Niños con amibiasis, giardiasis y blastocistosis. Respuesta clínica ante tres medicamentos

Abstract

Intestinal parasitosis is a frequent disease in children with diverse therapies and controversial effectiveness. The aim of this study was to compare the effectiveness of metronidazole, secnidazole and albendazole as monotherapies in children. 399 children were included and divided in three groups. Group A were of children with amoebiasis divided in two subgroups: A1 treated with metronidazole and A2 with secnidazole. Group B presented giardiasis. Subgroup B1 treated with metronidazole, B2 with secnidazole and B3 with albendazole. Group C presented blastocystosis and its subgroups C1 and C2 were treated with metronidazole and secnidazole respectively. Patients were children from two months to 14 years of age, attending the Autonomous University Hospital los Andes, Las Gonzalez Out-Patient Clinic and the La Azulita Hospital, in Merida state, Venezuela during 2005. The most frequent parasitosis was Entamoeba histolytica (49.1%), Blastocystis hominis (32.5%) and Giardia lamblia (18, 2%). Pre-school and school children were 52.1% and 64.3% from the suburban and rural areas. The clinical exam depended on the parasite etiology. We considered clinical improvement if the symptoms disappeared, and the parasitology was cured if the copro-analysis was negative. Children with amebiasis presented similar clinical improvement with both medicines and greater parasitological cure with secnidazole. Children with giardiasis showed greater clinical improvement and parasitology cure with secnidazole and low effectiveness with albendazole. Children with Blastocystis hominis showed greater clinical improvement and parasitology cure with metronidazole. We conclude that secnidazole has greater therapeutic effectiveness in children with amebiasis and giardiasis and metronidazole in children with Blastocystis hominis. We do not recommend albendazole against giardiasis