Giardia lamblia/duodenalis/intestinalis (Giardiasis)
May cause chronic diarrhea and mal-absorption.
May be asymptomatic. Treatment not routinely necessary if asymptomatic and little chance of transmission (e.g. non-institutionalized adult)
Refractory disease: combination therapy with metronidazole and quinacrine x 3 weeks may be effective.
Symptoms
- nausea
- anorexia
- watery, foul smelling diarrhea
- abdominal pain and distention
| Drug | Dose | Duration |
|---|---|---|
| Metronidazole | Adult: 250mg PO tid | 5-7 days |
| Paediatric: 15mg/kg/d PO div tid | 5-7 days |
Alternative
| Drug | Dose | Duration |
|---|---|---|
| Paromomycin | Adult & Paediatric: 25-35mg/kg/d PO div tid | 5-10 days |
| or | ||
| Nitazoxanide | Adult: 500mg PO bid | 3 days |
| Paediatric: 1-3 yo - 100mg PO bid | 3 days | |
| Paediatric: 4-11 yo - 200mg PO bid | 3 days | |
| or | ||
| Quinacrine | Adult: 100mg PO tid | 5 days |
| Paediatric: 6mg/kg/d PO div tid (max 300mg/day) | 5 days |
yo = years old