Pharmacotherapy of Giardiasais: Past, Present & Future

Objective: In view of the scattered information about pharmacotherapy of the common protozoal infestation in the English medical literature, this update aims at providing a state-of-the-art review concerning the drug therapy of giardiasis. Resource and Design: Systemic literature review augmented with authors' own first-hand experience in dealing with pediatric giardiasis spread over quite a few decades. Salient Features: Most subjects with giardiasis, a neglected disease, respond favorably to the available drugs though frequency of recurrences is high. However, immunocompromised persons pose the problem of less satisfactory response to routine pharmacotherapy, often necessitating a change in the drug regimen. In some cases, therapy needs to be complemented with other measures aimed at safeguarding against reinfection and passing infection to family members, peers and coworkers. Currently, albendazole, metronidazole, tinidazole and nitazoxanide stand out as the most acceptable amongst the plethora of drugs for giardiasis. Conclusion: Choosing an appropriate agent with attention to rationality in therapy plus preventive measures is mandatory to meet the challenge of giardiasis.