title: Azithromycin therapy for Cryptosporidium parvum infection in four children infected with human immunodeficiency virus.
abstract: Cryptosporidium parvum intestinal infection in immunodeficient patients can cause severe intestinal fluid losses with severe dehydration or chronic diarrhea with malnutrition. Therapies tried in human beings and animals include paromomycin, clarithromycin, azithromycin, octreotide, hyperimmune bovine colostrum, and bovine transfer factor. No specific therapy has been found to be consistently beneficial to children. We report azithromycin treatment of four children with acquired immunodeficiency syndrome who had severe diarrheal illnesses in which Cryptosporidium parvum was the sole pathogen detected. Three of these children had a marked decrease in stool volume and frequency within 36 hours of initiating therapy and resolution of diarrhea within 5 days; Cryptosporidium organisms became undetectable on examination of stool or colonic biopsy or by both after therapy was discontinued. A fourth patient required prolonged therapy with azithromycin to achieve clearance. Azithromycin therapy should be considered for immunocompromised patients with intestinal Cryptosporidium infection.
authors.affiliation: Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas 75235, USA.
authors.forename: P
authors.initials: P
authors.lastname: Hicks
authors.forename: R J
authors.initials: RJ
authors.lastname: Zwiener
authors.forename: J
authors.initials: J
authors.lastname: Squires
authors.forename: V
authors.initials: V
authors.lastname: Savell
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000293:Adolescent; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017963:Azithromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000469:parasitology; D003457:Cryptosporidiosis / Q000188:drug therapy*; D016785:Cryptosporidium parvum; D003967:Diarrhea / Q000188:drug therapy / Q000469:parasitology; D005243:Feces / Q000469:parasitology; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000188:drug therapy*; D008297:Male
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin