Treatment and prevention of giardiasis
- Flor M Munoz, MD, MSc
Flor M Munoz, MD, MSc
- Associate Professor of Pediatrics
- Baylor College of Medicine
- Section Editors
- Peter F Weller, MD, FACP
Peter F Weller, MD, FACP
- Editor-in-Chief — Infectious Diseases
- Section Editor — Tropical Medicine
- William Bosworth Castle Professor of Medicine
- Harvard Medical School
- Professor of Immunology and Infectious Diseases
- Harvard T. H. Chan School of Public Health
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
Giardia lamblia (also known as G. duodenalis or G. intestinalis) is a flagellated protozoan parasite [1-3]. G. lamblia causes both epidemic and sporadic disease and is an important etiology of waterborne and foodborne diarrhea, day-care center outbreaks, and diarrhea in international travelers and adoptees . The treatment and prevention of giardiasis will be reviewed here. The life cycle, epidemiology, clinical manifestations, and diagnosis of giardiasis are discussed separately. (See "Epidemiology, clinical manifestations, and diagnosis of giardiasis".)
Supportive measures for the treatment of individuals with symptomatic giardiasis are largely related to correction of fluid and electrolyte abnormalities that result from the diarrhea. (See "Clinical assessment and diagnosis of hypovolemia (dehydration) in children" and "Treatment of hypovolemia (dehydration) in children" and "Oral rehydration therapy".)
Indications — Symptomatic patients with giardiasis should be treated with antimicrobial therapy. Symptoms include diarrhea, malaise, steatorrhea, abdominal cramps, bloating, flatulence, nausea, and, especially in young children, weight loss and failure to thrive. (See "Epidemiology, clinical manifestations, and diagnosis of giardiasis", section on 'Clinical manifestations'.)
Patients with giardiasis should be counseled to avoid lactose-containing foods for at least one month after therapy . Acquired lactose intolerance occurs in up to 20 to 40 percent of cases and can take weeks or many months to resolve even after parasite clearance . (See "Epidemiology, clinical manifestations, and diagnosis of giardiasis".)
Treatment is not usually recommended for asymptomatic individuals [6,7]. However, treatment may be warranted to prevent the spread of infection if a patient is a household contact of a pregnant woman, an immunocompromised individual (especially in the setting of hypogammaglobulinemia), or a child in a day-care or other setting who might transmit infection to others [6,8]. (See 'Prevention' below.)
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- SUPPORTIVE CARE
- ANTIMICROBIAL THERAPY
- Treatment regimens
- - Nitroimidazoles
- - Nitazoxanide
- - Albendazole or mebendazole
- - Paromomycin
- - Furazolidone
- - Quinacrine
- Response to therapy
- RECURRENCE OF SYMPTOMS
- Infection control
- Waterborne infection
- Vitamin A
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS