title: Chemotherapy for giardiasis: randomized clinical trial of bacitracin, bacitracin zinc, and a combination of bacitracin zinc with neomycin.
abstract: This study describes a prospective, randomized, clinical trial in patients infected with the protozoa Giardia lamblia. Patients received a 10-day treatment with twice a day doses of either 120,000 U (USP) of bacitracin zinc, 120,000 U (USP) of bacitracin, 120,000 U (USP) of neomycin, or 60,000 U (USP) of bacitracin zinc and 60,000 U (USP) of neomycin. At the first assessment (day 11), all 21 subjects (100%) treated with bacitracin zinc had ceased to show Giardia parasites in their stools compared with 19 (95%) of 20 receiving bacitracin, 20 (90.9%) of 22 subjects receiving neomycin, and 17 (89.5%) of 19 subjects receiving bacitracin zinc plus neomycin. During the two-week follow up period, one (5.3%) of the 19 subjects examined who received bacitracin zinc experienced a recurrence compared with one (6.7%) of 15 receiving bacitracin, one (5.0%) of 20 receiving neomycin, and 0 (0%) of 14 receiving the combination treatment. Final cure rates of 94.7% for bacitracin zinc, 87.5% for bacitracin, 86.4% for neomycin, and 87.5% for bacitracin zinc plus neomycin were obtained. No synergistic activity was noted between bacitracin zinc and neomycin. Side effects were generally limited to nausea, abdominal discomfort, and diarrhea in a small number of patients.
authors.affiliation: Centre for International Health, University of Bergen, Haukeland Hospital, Norway.
authors.forename: B J
authors.initials: BJ
authors.lastname: Andrews
authors.forename: D
authors.initials: D
authors.lastname: Panitescu
authors.forename: G H
authors.initials: GH
authors.lastname: Jipa
authors.forename: A C
authors.initials: AC
authors.lastname: Vasile-Bugarin
authors.forename: R P
authors.initials: RP
authors.lastname: Vasiliu
authors.forename: J R
authors.initials: JR
authors.lastname: Ronnevig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D001414:Bacitracin / Q000627:therapeutic use*; D002648:Child; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005873:Giardiasis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009355:Neomycin / Q000627:therapeutic use*; D010349:Patient Compliance; D011446:Prospective Studies; D012008:Recurrence
chemical_list: D000981:Antiprotozoal Agents; D001414:Bacitracin; D009355:Neomycin