Efficacy of 5-nitroimidazoles for the treatment of giardiasis: a systematic review of randomized controlled trials.
BACKGROUND: Giardiasis is one of the most common causes of diarrheal disease worldwide and 5-nitroimidazoles (5-NI) are the most commonly prescribed drugs for the treatment of giardiasis. We evaluated the efficacy of 5-nitroimidazoles (5-NI) in the treatment of giardiasis in a systematic review of r...
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ftdoajarticles:oai:doaj.org/article:b56af490a598485390a0ba0b725eeb69 2023-05-15T15:14:31+02:00 Efficacy of 5-nitroimidazoles for the treatment of giardiasis: a systematic review of randomized controlled trials. Vinay Pasupuleti Angel Arturo Escobedo Abhishek Deshpande Priyaleela Thota Yuani Roman Adrian V Hernandez 2014-03-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0002733 https://doaj.org/article/b56af490a598485390a0ba0b725eeb69 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3953020?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002733 https://doaj.org/article/b56af490a598485390a0ba0b725eeb69 PLoS Neglected Tropical Diseases, Vol 8, Iss 3, p e2733 (2014) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2014 ftdoajarticles https://doi.org/10.1371/journal.pntd.0002733 2022-12-31T12:56:02Z BACKGROUND: Giardiasis is one of the most common causes of diarrheal disease worldwide and 5-nitroimidazoles (5-NI) are the most commonly prescribed drugs for the treatment of giardiasis. We evaluated the efficacy of 5-nitroimidazoles (5-NI) in the treatment of giardiasis in a systematic review of randomized controlled trials (RCTs). METHODOLOGY/PRINCIPAL FINDINGS: We conducted a comprehensive literature search in PubMed-Medline, Scopus, Web of Science and Cochrane Library for RCTs evaluating the efficacy of 5-NI vs. control (placebo or active treatment) on parasitological cure in patients with parasitologically-demonstrated giardiasis. The search was performed in May 2013 with no language restriction by two authors independently. The efficacy outcome was parasitological cure, and harmful outcomes were abdominal pain, bitter or metallic taste, and headache. We included 30 RCTs (n = 3,930). There was a significant and slightly higher response rate with 5-NI in giardiasis treatment (RR 1.06, 95%CI 1.02-1.11, p = 0.005). There was high heterogeneity among studies (I2 = 72%). The response rates for metronidazole, tinidazole and secnidazole were similar (RR 1.05, 95%CI 1.01-1.09, p = 0.01; RR 1.32 95%CI 1.10-1.59, p = 0.003; and RR 1.18 95%CI 0.93-1.449, p = 0.18, respectively). On subgroup analyses, the response rates did not vary substantially and high heterogeneity persisted (I2 = 57%-80%). Harmful outcomes were uncommon, and 5-NIs were associated with lower risk of abdominal pain, and higher risk of both bitter or metallic taste and headache. CONCLUSIONS: Studies investigating the efficacy of 5-NI in giardiasis treatment are highly heterogeneous. 5-NIs have a slightly better efficacy and worse profile for mild harmful outcomes in the treatment of giardiasis in comparison to controls. Larger high quality RCTs are needed to further assess efficacy and safety profiles of 5-NI. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 8 3 e2733 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Vinay Pasupuleti Angel Arturo Escobedo Abhishek Deshpande Priyaleela Thota Yuani Roman Adrian V Hernandez Efficacy of 5-nitroimidazoles for the treatment of giardiasis: a systematic review of randomized controlled trials. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND: Giardiasis is one of the most common causes of diarrheal disease worldwide and 5-nitroimidazoles (5-NI) are the most commonly prescribed drugs for the treatment of giardiasis. We evaluated the efficacy of 5-nitroimidazoles (5-NI) in the treatment of giardiasis in a systematic review of randomized controlled trials (RCTs). METHODOLOGY/PRINCIPAL FINDINGS: We conducted a comprehensive literature search in PubMed-Medline, Scopus, Web of Science and Cochrane Library for RCTs evaluating the efficacy of 5-NI vs. control (placebo or active treatment) on parasitological cure in patients with parasitologically-demonstrated giardiasis. The search was performed in May 2013 with no language restriction by two authors independently. The efficacy outcome was parasitological cure, and harmful outcomes were abdominal pain, bitter or metallic taste, and headache. We included 30 RCTs (n = 3,930). There was a significant and slightly higher response rate with 5-NI in giardiasis treatment (RR 1.06, 95%CI 1.02-1.11, p = 0.005). There was high heterogeneity among studies (I2 = 72%). The response rates for metronidazole, tinidazole and secnidazole were similar (RR 1.05, 95%CI 1.01-1.09, p = 0.01; RR 1.32 95%CI 1.10-1.59, p = 0.003; and RR 1.18 95%CI 0.93-1.449, p = 0.18, respectively). On subgroup analyses, the response rates did not vary substantially and high heterogeneity persisted (I2 = 57%-80%). Harmful outcomes were uncommon, and 5-NIs were associated with lower risk of abdominal pain, and higher risk of both bitter or metallic taste and headache. CONCLUSIONS: Studies investigating the efficacy of 5-NI in giardiasis treatment are highly heterogeneous. 5-NIs have a slightly better efficacy and worse profile for mild harmful outcomes in the treatment of giardiasis in comparison to controls. Larger high quality RCTs are needed to further assess efficacy and safety profiles of 5-NI. |
format |
Article in Journal/Newspaper |
author |
Vinay Pasupuleti Angel Arturo Escobedo Abhishek Deshpande Priyaleela Thota Yuani Roman Adrian V Hernandez |
author_facet |
Vinay Pasupuleti Angel Arturo Escobedo Abhishek Deshpande Priyaleela Thota Yuani Roman Adrian V Hernandez |
author_sort |
Vinay Pasupuleti |
title |
Efficacy of 5-nitroimidazoles for the treatment of giardiasis: a systematic review of randomized controlled trials. |
title_short |
Efficacy of 5-nitroimidazoles for the treatment of giardiasis: a systematic review of randomized controlled trials. |
title_full |
Efficacy of 5-nitroimidazoles for the treatment of giardiasis: a systematic review of randomized controlled trials. |
title_fullStr |
Efficacy of 5-nitroimidazoles for the treatment of giardiasis: a systematic review of randomized controlled trials. |
title_full_unstemmed |
Efficacy of 5-nitroimidazoles for the treatment of giardiasis: a systematic review of randomized controlled trials. |
title_sort |
efficacy of 5-nitroimidazoles for the treatment of giardiasis: a systematic review of randomized controlled trials. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2014 |
url |
https://doi.org/10.1371/journal.pntd.0002733 https://doaj.org/article/b56af490a598485390a0ba0b725eeb69 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 8, Iss 3, p e2733 (2014) |
op_relation |
http://europepmc.org/articles/PMC3953020?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002733 https://doaj.org/article/b56af490a598485390a0ba0b725eeb69 |
op_doi |
https://doi.org/10.1371/journal.pntd.0002733 |
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PLoS Neglected Tropical Diseases |
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8 |
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3 |
container_start_page |
e2733 |
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1766344959033606144 |