title: Evaluation of nitazoxanide for the treatment of disseminated cystic echinococcosis: report of five cases and literature review.
abstract: We aimed to evaluate the effectiveness of nitazoxanide in disseminated cystic echinococcosis (DCE) that failed to respond to surgical and antiparasitic therapy. We report on seven patients (five of them with bony involvement): two cases from the literature and five patients who were included in a compassionate trial of nitazoxanide therapy in our hospital. Median follow-up time until nitazoxanide therapy was 12 years and all patients had received prior medical treatment and extensive surgery. Nitazoxanide (500 mg/12 h) in combination with albendazole, with/without praziquantel, was administered for 3-24 months. Three patients improved: one with muscle involvement (clinico-radiological response), one with lung involvement (radiological response), and another with soft tissue and bony involvement (clinico-radiological response of soft tissue cysts). There was one discontinuation after 15 days of starting therapy. Nitazoxanide combination therapy could have a role in the treatment of DCE when there is no bony involvement. Long-term safety profile seems to be favorable.
authors.affiliation: Tropical Medicine, Infectious Diseases Department, Hospital Ramón y Cajal, IRICYS, Madrid, Spain. jose.perezmolina@gmail.com
authors.forename: José A
authors.initials: JA
authors.lastname: Pérez-Molina
authors.forename: Marta
authors.initials: M
authors.lastname: Díaz-Menéndez
authors.forename: José I
authors.initials: JI
authors.lastname: Gallego
authors.forename: Francesca
authors.initials: F
authors.lastname: Norman
authors.forename: Begoña
authors.initials: B
authors.lastname: Monge-Maillo
authors.forename: Ana Pérez
authors.initials: AP
authors.lastname: Ayala
authors.forename: Rogelio
authors.initials: R
authors.lastname: López-Vélez
mesh_terms: D000328:Adult; D000368:Aged; D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004443:Echinococcosis / Q000188:drug therapy* / Q000473:pathology; D048209:Echinococcus granulosus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009574:Nitro Compounds; D011223:Praziquantel / Q000008:administration & dosage / Q000627:therapeutic use; D013844:Thiazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000871:Anthelmintics; D009574:Nitro Compounds; D013844:Thiazoles; D011223:Praziquantel; D015766:Albendazole; C041747:nitazoxanide