Comparison Between Nitazoxanide and Metronidazole in the Treatment of Protozoal Diarrhea in Children

Abstract

Diarrheal disease is a leading cause of illness and death in children worldwide. Diarrhea is caused by a blend of bacterial, viral and parasitic pathogens. Enteric protozoal infections such as giardiasis, amebiasis and cryptosporidiosis are among the most common and most prevalent forms of gastrointestinal parasitic infections worldwide. Both nitazoxanide and metronidazole are used in treatment of protozoal diarrhea. Nitazoxanide was found to have a very broad spectrum of activity against many forms of parasites. Metronidazole also produces good results when it is used for treatment of parasitic infections. The aim in this study was to evaluate and compare the effect of nitazoxanide and metronidazole in treatment of protozoal diarrhea in children. This study was carried out on 160 diarrheic patients (83 males and 77 females), aged from 1-11 years old collected from the-clinics of pediatric department at Beni suef University Hospital. Patients were divided into two groups. Group A received Nitazoxanide 100 mg in 1-4 years aged patients and 200 mg in 4-11 years aged patients twice daily for 3 days respectively, Group B received Metronidazole 50 mg/Kg/body weight daily for 7 days. Patients were represented to full history taking, physical examination, laboratory investigations in the form of stool analysis, culture and complete blood count (CBC). There was a significant increase in the number of cases resolved by Nitazoxanide compared to Metronidazole group in both amebiasis and giardiasis (p-value < 0.05) with similar clinical improvement when using Nitazoxanide for 3 days and Metronidazole for 7 days. This study confirms the efficacy and safety of nitazoxanide as a 3-day treatment of diarrhea due to giardiasis & amebiasis in children. A 3-day course of nitazoxanide could replace much longer regimens of metronidazole