A comparison of metronidazole and single-dose ornidazole for the treatment of dientamoebiasis

Clin Microbiol Infect. 2008 Jun;14(6):601-4. doi: 10.1111/j.1469-0691.2008.02002.x. Epub 2008 Apr 5.

Abstract

Recent reports of the pathogenic potential of Dientamoeba fragilis have underlined the need for an effective treatment against this colon-dwelling protozoan. Metronidazole is a well-known and commonly used anti-protozoal agent, but another 5-nitroimidazole derivative, ornidazole, may be preferable, where available, because of its longer half-life and fewer side-effects. This study compared the efficacies of metronidazole and ornidazole in a group of 112 patients with dientamoebiasis. Patients were randomised into two treatment groups: group 1 (n = 56) received metronidazole for 5 days, 20 mg/kg/day for children and 1.5 g/day for adults, in three oral doses, while group 2 (n = 56) received a single oral dose of ornidazole, 30 mg/kg for children and 2 g for adults. Stool samples were examined on the seventh and 14th days after treatment, and clinical symptoms were recorded to evaluate the efficacy of treatment. A statistically significant difference was recorded between the efficacies of ornidazole and metronidazole, both parasitologically (92.9% vs. 69.6%, p 0.001) and clinically (96.4% vs. 76.8%, p 0.001). Patients in the metronidazole group reported more side-effects than patients in the ornidazole group, none of whom required termination of treatment. These results suggest that single-dose ornidazole may be an important alternative agent for the treatment of dientamoebiasis.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Amebicides / administration & dosage
  • Amebicides / adverse effects
  • Amebicides / therapeutic use*
  • Animals
  • Antiprotozoal Agents / administration & dosage
  • Antiprotozoal Agents / adverse effects
  • Antiprotozoal Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Dientamoeba / drug effects
  • Dientamoebiasis / drug therapy*
  • Feces / parasitology
  • Humans
  • Metronidazole / administration & dosage
  • Metronidazole / adverse effects
  • Metronidazole / therapeutic use*
  • Middle Aged
  • Ornidazole / administration & dosage
  • Ornidazole / adverse effects
  • Ornidazole / therapeutic use*

Substances

  • Amebicides
  • Antiprotozoal Agents
  • Metronidazole
  • Ornidazole