Treatment of cryptosporidiosis: do we know what we think we know?
OBJECTIVE
The management of cryptosporidiosis is fraught with controversies. New research on diagnostics and medications has reached the field in recent years. Therefore, familiarity with key features of current management tools is important. We discuss diagnostic and therapeutic aspects of cryptosporidiosis focusing on evidence behind the medications available to date.


RESULTS
Molecular methods provide a clearer understanding of cryptosporidiosis epidemiology. The major determinants of severity still are host immune status and parasite species. Children and immunosuppressed individuals, especially with HIV/AIDS, are disproportionately affected. Nitazoxanide is an important advance in treatment of HIV negative patients. However, recent research confirms the limited effectiveness of antiparasitic drugs to treat cryptosporidiosis in AIDS. Questions remain about using partially active drugs paromomycin and nitazoxanide for treatment. Potent antiretroviral combinations modify disease epidemiology and are key components of therapy in AIDS. However, it is unclear whether this is due solely to immune reconstitution or due in part to antiparasitic effects of HIV protease inhibitors. Newer candidate drugs are in development.


CONCLUSIONS
There is better understanding of the epidemiology of cryptosporidiosis and promising new diagnostic methods. There are significant challenges in terms of control and treatment of cryptosporidiosis among the groups at risk.
Cabada
Miguel M
MM
Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA.
White
A Clinton
AC
D000981:Antiprotozoal Agents / Q000627:therapeutic use; D003457:Cryptosporidiosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D003458:Cryptosporidium / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D017720:Molecular Epidemiology; D009574:Nitro Compounds; D013844:Thiazoles / Q000627:therapeutic use
D000981:Antiprotozoal Agents; D009574:Nitro Compounds; D013844:Thiazoles; C041747:nitazoxanide