Treatment of human intestinal cryptosporidiosis: A review of published clinical trials

Diptyanusa, Ajib and Sari, Ika Puspa (2021) Treatment of human intestinal cryptosporidiosis: A review of published clinical trials. International Journal for Parasitology: Drugs and Drug Resistance, 17. 128 – 138. ISSN 22113207

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Abstract

The global burden of diarrhea caused by Cryptosporidium parasite is underestimated. In immunocompromised hosts, chronic and severe presentation of intestinal cryptosporidiosis can result in long-term morbidity and high illness costs. The evidence of effective treatments for cryptosporidiosis has been lacking. We reviewed the published clinical trials to bring forward the feasible therapeutic options of human cryptosporidiosis in various populations and settings according to clinical improvement and parasite clearance rates. A total of 42 studies consisting of the use of nitazoxanide, paromomycin, macrolides, somatostatin analogues, letrazuril, albendazole, rifaximin, miltefosine, clofazimine, and colostrum were included in the review. The trials were mostly conducted in small number of individuals infected with human immunodeficiency virus (HIV), and there is inadequate data of controlled trials to suggest the use of these treatment modalities. Nitazoxanide was reported to be highly efficacious only in immunocompetent hosts and was found to be superior to paromomycin in the same group of patients. Macrolides showed no effective results in both clinical and parasitological improvement. Human bovine colostrum should possibly be administered as one of complementary therapeutic modalities along with other antimicrobials to reach optimal parasite eradication. Other trials of therapeutic modalities were terminated due to futility. Currently, available data is intended to aid the development of strategies for improving access to treatments in different clinical settings, as well as to help guide further studies on treatments of human intestinal cryptosporidiosis. © 2021

Item Type: Article
Additional Information: Cited by: 20; All Open Access, Gold Open Access, Green Open Access
Uncontrolled Keywords: Animals; Antiprotozoal Agents; Cattle; Cryptosporidiosis; Cryptosporidium; Diarrhea; Humans; Paromomycin; acetylspiramycin; albendazole; alkaline phosphatase; antiparasitic agent; azithromycin; clofazimine; erythromycin; garlicin; immunoglobulin; letrazuril; macrolide; miltefosine; nitazoxanide; octreotide; paromomycin; placebo; probiotic agent; rifaximin; roxithromycin; somatostatin derivative; spiramycin; unclassified drug; vapreotide; antiprotozoal agent; paromomycin; abdominal pain; adolescent; adult; aged; alkaline phosphatase level; alternative medicine; anorexia; antiparasitic therapy; child; cholecystitis; clinical trial (topic); colostrum; constipation; cryptosporidiosis; diarrhea; dizziness; drowsiness; drug efficacy; fatigue; fever; headache; health care access; human; Human immunodeficiency virus infection; hypertransaminasemia; infant; injection site pain; intestine obstruction; kidney disease; kidney failure; Lactobacillus rhamnosus; malaise; meta analysis; nausea; pancreatitis; parasite clearance; preschool child; randomized controlled trial (topic); rash; Review; school child; sclera disease; scleral discoloration; side effect; systematic review; urine discoloration; visual impairment; vomiting; xerostomia; young adult; animal; bovine; cryptosporidiosis; Cryptosporidium; diarrhea
Subjects: R Medicine > RB Biomedical Sciences
Divisions: Faculty of Medicine, Public Health and Nursing > Biomedical Sciences
Depositing User: Sri JUNANDI
Date Deposited: 28 Sep 2024 06:32
Last Modified: 28 Sep 2024 06:32
URI: https://ir.lib.ugm.ac.id/id/eprint/4453

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