Drugs for treating giardiasis (Cochrane Review)

A substantive amendment to this systematic review was last made on 10 April 1998. Cochrane reviews are regularly checked and updated if necessary.

Background: There can be a high rate of recurrence of disease after initial drug treatment for giardiasis. These drugs also have a range of adverse effects.

Objectives: The objective of this review was to assess the effects of drug treatments for giardiasis.

Search strategy: We searched the Cochrane Infectious Diseases Group trials register, the Cochrane Controlled Trials Register, Medline and Embase, Current Contents, reference lists of articles.

Selection criteria: Randomised and quasi-randomised trials of drug therapy for giardiasis compared with placebo or another drug.

Data collection and analysis: Two reviewers independently assessed trial quality and extracted data.

Main results: Thirty-four trials were included. Only one trial was without serious methodological flaws. Compared with placebo, drug treatment was associated with an improved cure rate (odds ratio 11.51, 95% confidence interval 2.29 to 57.98). Metronidazole treatment longer than three days had a better parasitological cure rate than other long treatment courses (odds ratio 2.41, 95% confidence interval 1.31 to 4.44), but there was significant heterogeneity between the trials. Available evidence has not detected a difference in cure between single dose therapy and longer treatment courses (odds ratio 0.33, 95% confidence interval 0.08 to 1.34). Within the single dose regimens, the available evidence did not demonstrate a difference in parasitological cure rate between tinidazole and other short therapies (odds ratio 3.39, 95% confidence interval 0.95 to 12.04), but had a higher clinical cure rate (odds ratio 5.33, 95% 2.66 to 10.67).

Reviewers' conclusions: A single dose of tinidazole appears to give the highest clinical cure rate for giardiasis with relatively few adverse effects.

Citation: Zaat JOM, Mank ThG, Assendelft WJJ. Drugs for treating giardiasis (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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File Reference: AB000217.htm