Giardiasis: Treatment and prevention
- Luther A Bartelt, MD
Luther A Bartelt, MD
- Assistant Professor
- The University of North Carolina School of Medicine
- Section Editors
- Peter F Weller, MD, MACP
Peter F Weller, MD, MACP
- 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 Giardia duodenalis or Giardia intestinalis) is a flagellated protozoan parasite . G. lamblia causes both epidemic and sporadic disease; it is an important etiology of waterborne and foodborne diarrhea and daycare center outbreaks [2-4].
Issues related to the treatment and prevention of giardiasis will be reviewed here. The life cycle, epidemiology, clinical manifestations, and diagnosis of giardiasis are discussed separately. (See "Giardiasis: Epidemiology, clinical manifestations, and diagnosis".)
Nonpregnant adults and children — The approach to treatment of symptomatic individuals with giardiasis includes antimicrobial therapy and supportive care (eg, correction of fluid and electrolyte abnormalities resulting from the diarrhea). (See "Clinical assessment and diagnosis of hypovolemia (dehydration) in children" and "Treatment of hypovolemia (dehydration) in children" and "Oral rehydration therapy".)
In general, administration of antimicrobial therapy for treatment of symptomatic individuals with giardiasis is appropriate. However, some infections are self-limited, and it is reasonable to forgo treatment for patients with mild symptoms and/or contraindications to antimicrobial therapy. (See 'Pregnant and lactating women' below.)
Symptoms of giardiasis include diarrhea, malaise, steatorrhea, abdominal cramps, bloating, flatulence, and nausea. In patients with chronic infection, diarrhea may not be a predominant symptom. In young children, symptoms may also include weight loss and failure to thrive. Symptoms of giardiasis are discussed further separately. (See "Giardiasis: Epidemiology, clinical manifestations, and diagnosis", section on 'Clinical manifestations'.)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- Initial approach
- - Nonpregnant adults and children
- Preferred agents
- - Tinidazole
- - Nitazoxanide
- Alternative agents
- - Metronidazole
- - Albendazole or mebendazole
- - Other agents
- - Pregnant and lactating women
- Persistent or recurrent symptoms
- - Evaluation
- - Management
- General principles
- - Infection control
- - Water and food transmission
- - Sexual transmission
- - Transmission from animals
- Resource-limited settings
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