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Paromomycin is superior to metronidazole in Dientamoeba fragilis treatment.
International Journal for Parasitology: Drugs and Drug Resistance ( IF 4 ) Pub Date : 2019-11-11 , DOI: 10.1016/j.ijpddr.2019.10.005
Ander Burgaña 1 , Rosa Abellana 2 , Stanislav Zlatanov Yordanov 1 , Rabee Kazan 1 , A Mauricio Pérez Ortiz 1 , Cristina Castillo Ramos 1 , Christian Garavito Hernández 1 , Miriam Molina Rivero 1 , Alessandra Queiroga Gonçalves 3 , Emma Padilla 4 , Josefa Pérez 4 , Roger García-Puig 5 , Tomas M Perez-Porcuna 6
Affiliation  

Dientamoeba fragilis is a trichomonad parasite of the human intestine that is found worldwide. However, the biological cycle and transmission of this parasite have yet to be elucidated. Although its pathogenic capacity has been questioned, there is increasing evidence that clinical manifestations vary greatly. Different therapeutic options with antiparasitic drugs are currently available; however, very few studies have compared the effectiveness of these drugs. In the present longitudinal study, we evaluate 13,983 copro-parasitological studies using light microscopy of stools, during 2013-2015, in Terrassa, Barcelona (Spain). A total of 1150 (8.2%) presented D. fragilis. Of these, 739 episodes were finally analyzed: those that involved a follow-up parasitology test up to 3 months later, corresponding to 586 patients with gastrointestinal symptoms (53% under 15 years of age). Coinfection by Blastocystis hominis was present in 33.6% of the subjects. Our aim was to compare therapeutic responses to different antiparasitic drugs and the factors associated with the persistence of D. fragilis post-treatment. Gender, age, and other intestinal parasitic coinfections were not associated with parasite persistence following treatment. Metronidazole was the therapeutic option in most cases, followed by paromomycin: 65.4% and 17.5% respectively. Paromomycin was found to be more effective at eradicating parasitic infection than metronidazole (81.8% vs. 65.4%; p = 0.007), except in children under six years of age (p = 0.538). Although Dientamoeba fragilis mainly produces mild clinical manifestations, the high burden of infection means we require better understanding of its epidemiological cycle and pathogenicity, as well as adequate therapeutic guidelines in order to adapt medical care and policies to respond to this health problem.

中文翻译:

在脆弱的Dientamoeba治疗中,巴龙霉素优于甲硝唑。

脆弱的Dientamoeba是在世界各地发现的人类肠道的滴虫寄生虫。但是,该寄生虫的生物周期和传播尚未阐明。尽管其致病能力受到质疑,但越来越多的证据表明临床表现差异很大。目前有抗寄生虫药的不同治疗选择。但是,很少有研究比较这些药物的有效性。在目前的纵向研究中,我们评估了2013-2015年间在西班牙巴塞罗那的Terrassa使用粪便的光学显微镜进行的13983项寄生虫学研究。共有1150个(8.2%)呈现了脆弱的D. 其中,最终分析了739次发作:直到3个月后才进行了后续寄生虫学测试的发作,对应于586位有胃肠道症状的患者(53岁以下的患者占53%)。33.6%的受试者存在人乳芽孢杆菌的合并感染。我们的目的是比较对不同抗寄生虫药物的治疗反应以及与脆弱性衣原体持续治疗相关的因素。性别,年龄和其他肠道寄生虫合并感染与治疗后的寄生虫持久性无关。在大多数情况下,甲硝唑是治疗选择,其次是巴龙霉素:分别为65.4%和17.5%。除六岁以下儿童(p = 0.538)外,发现巴龙霉素在消除寄生虫感染方面比甲硝唑更有效(81.8%vs. 65.4%; p = 0.007)。尽管脆弱的Dientamoeba主要产生轻度的临床表现,
更新日期:2019-11-01
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