Albendazole versus metronidazole in the treatment of adult giardiasis: a randomized, double-blind, clinical trial

Abstract

Background:

Albendazole (ABZ) is a benzimidazole carbamate compound currently in use for human medical practice against enterobiasis and soil-transmitted helminthiasis (STH); However, its spectrum of activity is broad and goes beyond these infections.

Objective:

This study compares the efficacy and safety of ABZ versus metronidazole (MTZ) in human giardiasis.

Research design and methods:

A randomized, double-blind, clinical trial was carried out at the Centre of Hygiene, Epidemiology and Microbiology in Matanzas City, Cuba. Adult patients with confirmed symptomatic G. duodenalis mono-infection were randomly assigned to receive either ABZ [400 mg daily (n = 75)] or MTZ [250 mg t.i.d. (n = 75)], both for 5 days. Follow-up fecal samples were obtained at 3, 5, 7 days after treatment end.

Results:

The efficacy was similar for both treatment groups: ABZ (82.6%) and MTZ (85.3%); p > 0.05. Side-effects including bitter taste, headache, vomiting and dizziness were significantly higher in the MTZ group. Abdominal pain was significantly higher in ABZ group.

Conclusion:

ABZ was found as effective as MTZ in the treatment of G. duodenalis infections in adult patients from Cuba and could be a useful drug in areas where co-infection with STH infections is common.

Key words::

• Albendazole
• Benzimidazoles
• Giardia duodenalis
• Metronidazole

Transparency

Declaration of funding

The authors have received no payment for preparation of this manuscript.

Declaration of financial/other relationships

The authors declare no conflict of interest.

Acknowledgments

The authors wish to thank Indira Canete-Villafranca for her assistance in the preparation and reviewing of the manuscript.

CMRO peer reviewers have declared no relevant financial relationships.