Treatment of human intestinal cryptosporidiosis: A review of published clinical trials
The global burden of diarrhea caused by Cryptosporidium parasite is underestimated. In immunocompromised hosts, chronic and severe presentation of intestinal cryptosporidiosis can result in long-term morbidity and high illness costs. The evidence of effective treatments for cryptosporidiosis has bee...
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doaj-32595848e50e4c2386622b45065b7a5a2021-09-23T04:38:42ZengElsevierInternational Journal for Parasitology: Drugs and Drug Resistance2211-32072021-12-0117128138Treatment of human intestinal cryptosporidiosis: A review of published clinical trialsAjib Diptyanusa0Ika Puspa Sari1Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia; Study Program of Medical Specialist in Clinical Parasitology, Faculty of Medicine, University of Indonesia, Indonesia; Corresponding author. Department of Parasitology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Farmako, Sekip Utara, Yogyakarta, 55281, Indonesia.Department of Parasitology, Faculty of Medicine, University of Indonesia, IndonesiaThe global burden of diarrhea caused by Cryptosporidium parasite is underestimated. In immunocompromised hosts, chronic and severe presentation of intestinal cryptosporidiosis can result in long-term morbidity and high illness costs. The evidence of effective treatments for cryptosporidiosis has been lacking. We reviewed the published clinical trials to bring forward the feasible therapeutic options of human cryptosporidiosis in various populations and settings according to clinical improvement and parasite clearance rates. A total of 42 studies consisting of the use of nitazoxanide, paromomycin, macrolides, somatostatin analogues, letrazuril, albendazole, rifaximin, miltefosine, clofazimine, and colostrum were included in the review. The trials were mostly conducted in small number of individuals infected with human immunodeficiency virus (HIV), and there is inadequate data of controlled trials to suggest the use of these treatment modalities. Nitazoxanide was reported to be highly efficacious only in immunocompetent hosts and was found to be superior to paromomycin in the same group of patients. Macrolides showed no effective results in both clinical and parasitological improvement. Human bovine colostrum should possibly be administered as one of complementary therapeutic modalities along with other antimicrobials to reach optimal parasite eradication. Other trials of therapeutic modalities were terminated due to futility. Currently, available data is intended to aid the development of strategies for improving access to treatments in different clinical settings, as well as to help guide further studies on treatments of human intestinal cryptosporidiosis.http://www.sciencedirect.com/science/article/pii/S2211320721000440CryptosporidiumCryptosporidiosisTreatmentDrugClinical trialClearance |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ajib Diptyanusa Ika Puspa Sari |
spellingShingle |
Ajib Diptyanusa Ika Puspa Sari Treatment of human intestinal cryptosporidiosis: A review of published clinical trials International Journal for Parasitology: Drugs and Drug Resistance Cryptosporidium Cryptosporidiosis Treatment Drug Clinical trial Clearance |
author_facet |
Ajib Diptyanusa Ika Puspa Sari |
author_sort |
Ajib Diptyanusa |
title |
Treatment of human intestinal cryptosporidiosis: A review of published clinical trials |
title_short |
Treatment of human intestinal cryptosporidiosis: A review of published clinical trials |
title_full |
Treatment of human intestinal cryptosporidiosis: A review of published clinical trials |
title_fullStr |
Treatment of human intestinal cryptosporidiosis: A review of published clinical trials |
title_full_unstemmed |
Treatment of human intestinal cryptosporidiosis: A review of published clinical trials |
title_sort |
treatment of human intestinal cryptosporidiosis: a review of published clinical trials |
publisher |
Elsevier |
series |
International Journal for Parasitology: Drugs and Drug Resistance |
issn |
2211-3207 |
publishDate |
2021-12-01 |
description |
The global burden of diarrhea caused by Cryptosporidium parasite is underestimated. In immunocompromised hosts, chronic and severe presentation of intestinal cryptosporidiosis can result in long-term morbidity and high illness costs. The evidence of effective treatments for cryptosporidiosis has been lacking. We reviewed the published clinical trials to bring forward the feasible therapeutic options of human cryptosporidiosis in various populations and settings according to clinical improvement and parasite clearance rates. A total of 42 studies consisting of the use of nitazoxanide, paromomycin, macrolides, somatostatin analogues, letrazuril, albendazole, rifaximin, miltefosine, clofazimine, and colostrum were included in the review. The trials were mostly conducted in small number of individuals infected with human immunodeficiency virus (HIV), and there is inadequate data of controlled trials to suggest the use of these treatment modalities. Nitazoxanide was reported to be highly efficacious only in immunocompetent hosts and was found to be superior to paromomycin in the same group of patients. Macrolides showed no effective results in both clinical and parasitological improvement. Human bovine colostrum should possibly be administered as one of complementary therapeutic modalities along with other antimicrobials to reach optimal parasite eradication. Other trials of therapeutic modalities were terminated due to futility. Currently, available data is intended to aid the development of strategies for improving access to treatments in different clinical settings, as well as to help guide further studies on treatments of human intestinal cryptosporidiosis. |
topic |
Cryptosporidium Cryptosporidiosis Treatment Drug Clinical trial Clearance |
url |
http://www.sciencedirect.com/science/article/pii/S2211320721000440 |
work_keys_str_mv |
AT ajibdiptyanusa treatmentofhumanintestinalcryptosporidiosisareviewofpublishedclinicaltrials AT ikapuspasari treatmentofhumanintestinalcryptosporidiosisareviewofpublishedclinicaltrials |
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