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Andreas Neumayr - One of the best experts on this subject based on the ideXlab platform.
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efficacy and tolerability of quinacrine monotherapy and albendazole plus chloroquine combination therapy in nitroimidazole refractory Giardiasis a tropnet study
Clinical Infectious Diseases, 2021Co-Authors: Andreas Neumayr, Mirjam Schunk, Caroline Theunissen, Marjan Van Esbroeck, Matthieu Mechain, Christoph Hatz, Kristine MorchAbstract:Background Giardiasis failing nitroimidazole first-line treatment is an emerging problem in returning European travelers. We present data on the efficacy and tolerability of 2 second-line treatment regimens. Methods This prospective, open-label, multicenter study assessed the efficacy and tolerability of quinacrine monotherapy (100 mg 3 times per day for 5 days) and albendazole plus chloroquine combination therapy (400 mg twice daily plus 155 mg twice daily for 5 days) in nitroimidazole-refractory Giardiasis. The defined end points were the clinical outcome, assessed at week 5 after treatment and the parasitological outcome, assessed using microscopy of 2 stool samples, ≥2 to ≤5 weeks after treatment. Results A total of 106 patients were included in the study. Quinacrine achieved clinical and parasitological cure in 81% (59/73) and 100% (56/56), respectively. Albendazole plus chloroquine achieved clinical and parasitological cure in 36% (12/33) and 48% (12/25), respectively. All patients (9/9) who clinically and parasitologically failed albendazole plus chloroquine treatment and opted for retreatment with quinacrine achieved clinical cure. Mild to moderate treatment-related adverse events were reported by 45% and 30% of patients treated with quinacrine and albendazole plus chloroquine, respectively. One patient treated with quinacrine developed severe neuropsychiatric side effects. The majority of nitroimidazole-refractory Giardia infections (57%) were acquired in India. Conclusions Quinacrine was a highly effective treatment in nitroimidazole-refractory Giardiasis, but patients should be cautioned on the low risk of severe neuropsychiatric adverse event. Albendazole plus chloroquine had a low cure rate in nitroimidazole-refractory Giardiasis. Nitroimidazole-refractory Giardiasis was primarily seen in travelers returning from India.
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treatment strategies for nitroimidazole refractory Giardiasis a systematic review
Journal of Travel Medicine, 2021Co-Authors: Daniel L Bourque, Andreas Neumayr, Michael Libman, Lin H ChenAbstract:Rationale for review: Giardiasis is one of the most common human protozoal infections worldwide. First line therapy of Giardiasis includes nitroimidazole antibiotics. However, treatment failure with nitroimidazoles is increasingly reported with up to 45% of patients not responding to initial treatment. There is no clear consensus on the approach to the management of nitroimidazole refractory Giardiasis. This systematic review aims to summarize the literature on pharmacotherapy for nitroimidazole refractory Giardiasis. METHODS We conducted a systematic review of the literature to determine the optimal management strategies for nitroimidazole refractory Giardiasis. We searched Pubmed/MEDLINE, Embase, and Cochrane library using the following search terms 'Giardia' AND 'treatment failure' OR 'refractory giardia' OR 'resistant giardia' with date limits of January 1, 1970 to June 30, 2021. We included all reports on humans which described clinical outcomes of individuals with treatment refractory Giardiasis, including case series and case reports. A descriptive synthesis of the data was conducted with pooling of data for interventions. KEY FINDINGS Included in this review were 5 prospective studies, 3 retrospective studies, 7 case series and 9 case reports. Across these reports, a wide heterogeneity of treatment regimens was employed, including re-treatment with an alternative nitroimidazole, combination therapy with a nitroimidazole and another agent, and monotherapy with non-nitroimidazole regimens including quinacrine, paromomycin and nitazoxanide. Retreatment with a nitroimidazole was not an effective therapy for refractory Giardiasis. However, treatment with a nitroimidazole in combination with albendazole had a cure rate of 66.9%. In the included studies, quinacrine monotherapy was administered to a total of 179 patients with a clinical cure rate of 88.8%. Overall, quinacrine was fairly well tolerated. CONCLUSIONS Reports on the treatment of nitroimidazole refractory Giardiasis demonstrate a heterogeneous approach to treatment. Of these, quinacrine appeared to be highly effective though more data on its safety is needed.
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efficacy and tolerability of quinacrine monotherapy and albendazole plus chloroquine combination therapy in nitroimidazole refractory Giardiasis a tropnet study
Clinical Infectious Diseases, 2021Co-Authors: Andreas Neumayr, Mirjam Schunk, Caroline Theunissen, Marjan Van Esbroeck, Matthieu Mechain, Christoph Hatz, Kristine MorchAbstract:Background Giardiasis failing nitroimidazole first-line treatment is an emerging clinical problem in returning European travelers. We present data on the efficacy and tolerability of two second-line treatment regimens. Methods Prospective, open-label, multi-center study assessing the efficacy and tolerability of quinacrine monotherapy (100mg TID for 5 days) and albendazole plus chloroquine combination therapy (400mg BID plus 155mg BID for 5 days) in nitroimidazole-refractory Giardiasis, defined as cases with persisting or relapsing infection despite single or repeated courses of nitroimidazole treatment. The defined endpoints were the clinical outcome, assessed by a questionnaire, at week 5 after treatment and the parasitological outcome, assessed by microscopy of 2 stool samples, ≥2-≤5 weeks after treatment. Result 106 patients were included in the study. Quinacrine achieved clinical and parasitological cure in 81% (59/73) and 100% (56/56), respectively. Albendazole plus chloroquine achieved clinical and parasitological cure in 36% (12/33) and 48% (12/25), respectively. All patients (9/9) who clinically and parasitologically failed albendazole plus chloroquine treatment and opted for re-treatment with quinacrine achieved clinical cure. Mild to moderate treatment-related adverse events were reported by 45% and 30% of patients treated with quinacrine and albendazole plus chloroquine, respectively. One patient treated with quinacrine developed severe neuropsychiatric side effects. The majority of nitroimidazole-refractory Giardia infections (57%) were acquired in India. Conclusion Quinacrine was a highly effective treatment in nitroimidazole-refractory Giardiasis, but patients should be cautioned on the low risk of severe neuropsychiatric adverse event. Albendazole plus chloroquine had a low cure rate in nitroimidazole-refractory Giardiasis. Nitroimidazole-refractory Giardiasis was primarily seen in travelers returning from India.
Kristine Morch - One of the best experts on this subject based on the ideXlab platform.
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efficacy and tolerability of quinacrine monotherapy and albendazole plus chloroquine combination therapy in nitroimidazole refractory Giardiasis a tropnet study
Clinical Infectious Diseases, 2021Co-Authors: Andreas Neumayr, Mirjam Schunk, Caroline Theunissen, Marjan Van Esbroeck, Matthieu Mechain, Christoph Hatz, Kristine MorchAbstract:Background Giardiasis failing nitroimidazole first-line treatment is an emerging problem in returning European travelers. We present data on the efficacy and tolerability of 2 second-line treatment regimens. Methods This prospective, open-label, multicenter study assessed the efficacy and tolerability of quinacrine monotherapy (100 mg 3 times per day for 5 days) and albendazole plus chloroquine combination therapy (400 mg twice daily plus 155 mg twice daily for 5 days) in nitroimidazole-refractory Giardiasis. The defined end points were the clinical outcome, assessed at week 5 after treatment and the parasitological outcome, assessed using microscopy of 2 stool samples, ≥2 to ≤5 weeks after treatment. Results A total of 106 patients were included in the study. Quinacrine achieved clinical and parasitological cure in 81% (59/73) and 100% (56/56), respectively. Albendazole plus chloroquine achieved clinical and parasitological cure in 36% (12/33) and 48% (12/25), respectively. All patients (9/9) who clinically and parasitologically failed albendazole plus chloroquine treatment and opted for retreatment with quinacrine achieved clinical cure. Mild to moderate treatment-related adverse events were reported by 45% and 30% of patients treated with quinacrine and albendazole plus chloroquine, respectively. One patient treated with quinacrine developed severe neuropsychiatric side effects. The majority of nitroimidazole-refractory Giardia infections (57%) were acquired in India. Conclusions Quinacrine was a highly effective treatment in nitroimidazole-refractory Giardiasis, but patients should be cautioned on the low risk of severe neuropsychiatric adverse event. Albendazole plus chloroquine had a low cure rate in nitroimidazole-refractory Giardiasis. Nitroimidazole-refractory Giardiasis was primarily seen in travelers returning from India.
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efficacy and tolerability of quinacrine monotherapy and albendazole plus chloroquine combination therapy in nitroimidazole refractory Giardiasis a tropnet study
Clinical Infectious Diseases, 2021Co-Authors: Andreas Neumayr, Mirjam Schunk, Caroline Theunissen, Marjan Van Esbroeck, Matthieu Mechain, Christoph Hatz, Kristine MorchAbstract:Background Giardiasis failing nitroimidazole first-line treatment is an emerging clinical problem in returning European travelers. We present data on the efficacy and tolerability of two second-line treatment regimens. Methods Prospective, open-label, multi-center study assessing the efficacy and tolerability of quinacrine monotherapy (100mg TID for 5 days) and albendazole plus chloroquine combination therapy (400mg BID plus 155mg BID for 5 days) in nitroimidazole-refractory Giardiasis, defined as cases with persisting or relapsing infection despite single or repeated courses of nitroimidazole treatment. The defined endpoints were the clinical outcome, assessed by a questionnaire, at week 5 after treatment and the parasitological outcome, assessed by microscopy of 2 stool samples, ≥2-≤5 weeks after treatment. Result 106 patients were included in the study. Quinacrine achieved clinical and parasitological cure in 81% (59/73) and 100% (56/56), respectively. Albendazole plus chloroquine achieved clinical and parasitological cure in 36% (12/33) and 48% (12/25), respectively. All patients (9/9) who clinically and parasitologically failed albendazole plus chloroquine treatment and opted for re-treatment with quinacrine achieved clinical cure. Mild to moderate treatment-related adverse events were reported by 45% and 30% of patients treated with quinacrine and albendazole plus chloroquine, respectively. One patient treated with quinacrine developed severe neuropsychiatric side effects. The majority of nitroimidazole-refractory Giardia infections (57%) were acquired in India. Conclusion Quinacrine was a highly effective treatment in nitroimidazole-refractory Giardiasis, but patients should be cautioned on the low risk of severe neuropsychiatric adverse event. Albendazole plus chloroquine had a low cure rate in nitroimidazole-refractory Giardiasis. Nitroimidazole-refractory Giardiasis was primarily seen in travelers returning from India.
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irritable bowel syndrome and chronic fatigue 3 years after acute Giardiasis historic cohort study
Gut, 2012Co-Authors: Knutarne Wensaas, Kristine Morch, Kurt Hanevik, Nina Langeland, Geir Egil Eide, Guri RortveitAbstract:Background Giardia lamblia is a common cause of gastroenteritis worldwide, but there is limited knowledge about the long-term complications. Objective To estimate the relative risk of irritable bowel syndrome (IBS) and chronic fatigue 3 years after acute Giardiasis. Design Controlled historic cohort study with 3 years9 follow-up. Data collected by mailed questionnaire. Setting Waterborne outbreak of Giardiasis in the city of Bergen, Norway. Participants 817 patients exposed to Giardia lamblia infection verified by detection of cysts in stool samples and 1128 matched controls. Main outcome measures IBS and chronic fatigue. Results The prevalence of IBS in the exposed group was 46.1%, compared with 14.0% in the control group, and the adjusted RR=3.4 (95% CI 2.9 to 3.8). Chronic fatigue was reported by 46.1% of the exposed group and 12.0% of the controls, the adjusted RR was 4.0 (95% CI 3.5 to 4.5). IBS and chronic fatigue were associated and the RR for the exposed group of having a combination of the two outcomes was 6.8 (95% CI 5.3 to 8.5). The RR was also increased for having just one of the two syndromes, 1.8 for IBS (95% CI 1.4 to 2.3) and 2.2 for chronic fatigue (95% CI 1.7 to 2.8). Conclusions Infection with Giardia lamblia in a non-endemic area was associated with a high prevalence of IBS and chronic fatigue 3 years after acute illness, and the risk was significantly higher than in the control group. This shows that the potential consequences of Giardiasis are more serious than previously known. Further studies are needed, especially in areas where Giardiasis is endemic.
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treatment ladder and genetic characterisation of parasites in refractory Giardiasis after an outbreak in norway
Journal of Infection, 2008Co-Authors: Kristine Morch, Kurt Hanevik, Lucy J Robertson, Elin Strand, Nina LangelandAbstract:Summary Objectives To evaluate the efficacy of a treatment ladder in metronidazole-refractory Giardiasis, and to compare genetic characteristics of the parasites. Methods A clinical observational study was carried out in 38 adult patients with metronidazole-refractory Giardiasis, during an outbreak in Norway with more than 1200 cases. All patients were treated with albendazole in combination with metronidazole. Those who failed were treated with paromomycin. Those who failed on paromomycin were treated with quinacrine in combination with metronidazole. Giardia isolates from 17 patients were characterised by PCR and sequencing at two separate genes. Results Metronidazole in combination with albendazole was effective in 30 (79%) out of 38 patients. Paromomycin was effective in three out of six patients. Quinacrine in combination with metronidazole was effective in 3 patients. Molecular characterisation of the Giardia isolates revealed that these parasites were identical at two different gene segments, while sequence profiles from isolates at the peak of the outbreak were more heterogenous. Conclusions Albendazole and quinacrine both in combination with metronidazole were effective in treating metronidazole-refractory Giardiasis in this cohort. Paromomycin was less effective. Particular Giardia sub-genotypes may have been associated with the treatment-refractory Giardiasis in these patients, although other undefined factors are probably also of importance.
Christoph Hatz - One of the best experts on this subject based on the ideXlab platform.
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efficacy and tolerability of quinacrine monotherapy and albendazole plus chloroquine combination therapy in nitroimidazole refractory Giardiasis a tropnet study
Clinical Infectious Diseases, 2021Co-Authors: Andreas Neumayr, Mirjam Schunk, Caroline Theunissen, Marjan Van Esbroeck, Matthieu Mechain, Christoph Hatz, Kristine MorchAbstract:Background Giardiasis failing nitroimidazole first-line treatment is an emerging problem in returning European travelers. We present data on the efficacy and tolerability of 2 second-line treatment regimens. Methods This prospective, open-label, multicenter study assessed the efficacy and tolerability of quinacrine monotherapy (100 mg 3 times per day for 5 days) and albendazole plus chloroquine combination therapy (400 mg twice daily plus 155 mg twice daily for 5 days) in nitroimidazole-refractory Giardiasis. The defined end points were the clinical outcome, assessed at week 5 after treatment and the parasitological outcome, assessed using microscopy of 2 stool samples, ≥2 to ≤5 weeks after treatment. Results A total of 106 patients were included in the study. Quinacrine achieved clinical and parasitological cure in 81% (59/73) and 100% (56/56), respectively. Albendazole plus chloroquine achieved clinical and parasitological cure in 36% (12/33) and 48% (12/25), respectively. All patients (9/9) who clinically and parasitologically failed albendazole plus chloroquine treatment and opted for retreatment with quinacrine achieved clinical cure. Mild to moderate treatment-related adverse events were reported by 45% and 30% of patients treated with quinacrine and albendazole plus chloroquine, respectively. One patient treated with quinacrine developed severe neuropsychiatric side effects. The majority of nitroimidazole-refractory Giardia infections (57%) were acquired in India. Conclusions Quinacrine was a highly effective treatment in nitroimidazole-refractory Giardiasis, but patients should be cautioned on the low risk of severe neuropsychiatric adverse event. Albendazole plus chloroquine had a low cure rate in nitroimidazole-refractory Giardiasis. Nitroimidazole-refractory Giardiasis was primarily seen in travelers returning from India.
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efficacy and tolerability of quinacrine monotherapy and albendazole plus chloroquine combination therapy in nitroimidazole refractory Giardiasis a tropnet study
Clinical Infectious Diseases, 2021Co-Authors: Andreas Neumayr, Mirjam Schunk, Caroline Theunissen, Marjan Van Esbroeck, Matthieu Mechain, Christoph Hatz, Kristine MorchAbstract:Background Giardiasis failing nitroimidazole first-line treatment is an emerging clinical problem in returning European travelers. We present data on the efficacy and tolerability of two second-line treatment regimens. Methods Prospective, open-label, multi-center study assessing the efficacy and tolerability of quinacrine monotherapy (100mg TID for 5 days) and albendazole plus chloroquine combination therapy (400mg BID plus 155mg BID for 5 days) in nitroimidazole-refractory Giardiasis, defined as cases with persisting or relapsing infection despite single or repeated courses of nitroimidazole treatment. The defined endpoints were the clinical outcome, assessed by a questionnaire, at week 5 after treatment and the parasitological outcome, assessed by microscopy of 2 stool samples, ≥2-≤5 weeks after treatment. Result 106 patients were included in the study. Quinacrine achieved clinical and parasitological cure in 81% (59/73) and 100% (56/56), respectively. Albendazole plus chloroquine achieved clinical and parasitological cure in 36% (12/33) and 48% (12/25), respectively. All patients (9/9) who clinically and parasitologically failed albendazole plus chloroquine treatment and opted for re-treatment with quinacrine achieved clinical cure. Mild to moderate treatment-related adverse events were reported by 45% and 30% of patients treated with quinacrine and albendazole plus chloroquine, respectively. One patient treated with quinacrine developed severe neuropsychiatric side effects. The majority of nitroimidazole-refractory Giardia infections (57%) were acquired in India. Conclusion Quinacrine was a highly effective treatment in nitroimidazole-refractory Giardiasis, but patients should be cautioned on the low risk of severe neuropsychiatric adverse event. Albendazole plus chloroquine had a low cure rate in nitroimidazole-refractory Giardiasis. Nitroimidazole-refractory Giardiasis was primarily seen in travelers returning from India.
Hilmir Asgeirsson - One of the best experts on this subject based on the ideXlab platform.
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quinacrine treatment of nitroimidazole refractory Giardiasis
The Journal of Infectious Diseases, 2021Co-Authors: Karin A Ydsten, Urban Hellgren, Hilmir AsgeirssonAbstract:BACKGROUND Limited evidence exists on the efficacy and tolerability of quinacrine for nitroimidazole-refractory Giardiasis. METHODS Nitroimidazole-refractory Giardiasis cases, defined as microbiologically (microscopy and/or PCR) confirmed treatment failure after two courses, during 2008-2020, were retrospectively identified. RESULTS Of 87 patients, 54 (62%) had visited India. Quinacrine was used in 54 (62%); 51 received monotherapy and three combined with metronidazole. Only three had positive stool samples with persisting symptoms after quinacrine treatment (94% parasitological efficacy), and all were cured after a second treatment. One (1.9%) had mild adverse effects recorded. CONCLUSIONS Quinacrine is an effective treatment for nitroimidazole-refractory Giardiasis with good tolerability.
Steven M Singer - One of the best experts on this subject based on the ideXlab platform.
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Giardiasis alters intestinal fatty acid binding protein i fabp and plasma cytokines levels in children in brazil
Pathogenetics, 2019Co-Authors: Tiara Cascaisfigueiredo, Camila H Coelho, Phelipe Austriacoteixeira, Maria Fantinatti, Maria Luciana Silvafreitas, Joanna Reis Santosoliveira, Steven M SingerAbstract:Giardiasis is an intestinal infection caused by ingestion of water or food contaminated with cysts of Giardia lamblia. Susceptibility is higher in children and overall prevalence can reach up to 90% in low-income areas, although outbreaks are also reported in developed countries. Both parasite and immune-mediated epithelial damage has been observed in vitro and in animal models. However, whether enterocytes are directly damaged during infection is not entirely known. Our goal was to identify whether plasma levels of intestinal fatty acid binding protein (I-FABP), a marker of enterocyte damage, are related to the immune response in Giardiasis. Blood plasma was collected from 31 children (19 Giardia-positive) from a public day care in Rio de Janeiro, Brazil. The levels of I-FABP were increased in Giardia-infected children compared to children without detectable infection. There was no difference in I-FABP levels in Giardiasis caused by different genetic assemblages of Giardia. Levels of IL-8 were decreased, while there was a trend to elevated IL-17 in the Giardia-positive children. A positive correlation was observed between I-FABP and IL-17 levels as well as TNF, suggesting that epithelial damage can be related to cytokine production during Giardiasis. These results help elucidate the relationship between the disruption of the intestinal mucosal barrier and immune responses to G. lamblia in children.
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Giardiasis as a neglected disease in brazil systematic review of 20 years of publications
PLOS Neglected Tropical Diseases, 2017Co-Authors: Camila H Coelho, Mauricio Durigan, Diego Averaldo Guiguet Leal, Adriano De Bernardi Schneider, Regina Maura Bueno Franco, Steven M SingerAbstract:Introduction Giardiasis is an intestinal infection that affects more than two hundred million people annually worldwide; it is caused by the flagellated protozoan Giardia duodenalis. In tropical countries and in low or middle-income settings, like Brazil, its prevalence can be high. There is currently no systematic review on the presence of G. duodenalis in patients, animals or water sources in Brazil. Methods This systematic review was performed according to recommendations established by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). As databases for our searches, we have used PubMed, Embase, Scopus and the Brazilian database SciELO using the keywords «Giardia*» and «Brazil». Results This systematic review identified research studies related to G. duodenalis in water, Giardiasis in animals, prevalence of Giardiasis across Brazilian regions, genotyping of strains isolated in humans, and Giardiasis in indigenous populations. We also propose a network of G. duodenalis transmission in Brazil based on genotypes analyses. Conclusion This is the first time within the last twenty years that a review is being published on the occurrence of G. duodenalis in Brazil, addressing relevant issues such as prevalence, molecular epidemiology and analytical methods for parasite detection. Non-technical summary Giardiasis is an intestinal disease that affect millions of people worldwide, including children. Its main route of transmission is by ingestion of food or water contaminated with the protozoan G. duodenalis. Transmission does not require an animal host, although transmission from animals to human (zoonotic transmission) has been confirmed as an important vector of human Giardiasis. This study is a comprehensive description of the impact of Giardiasis in Brazil based on studies published in the country from the past 20 years. We describe Giardia prevalence in humans (including indigenous populations), animals and water supplies. In addition, we create a transmission network model for the disease, based on genotype data previously identified in animal and human hosts as well as in environmental samples. The data compiled here will be useful for design of policies to prevent Giardiasis transmission in Brazil.
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giardia duodenalis the double edged sword of immune responses in Giardiasis
Experimental Parasitology, 2010Co-Authors: Shahram Solaymanimohammadi, Steven M SingerAbstract:Giardiasis is one of the most common intestinal protozoan infections worldwide. The etiological agent, Giardia duodenalis (syn. Giardia lamblia, Giardia intestinalis), is a flagellated, binucleated protozoan parasite which infects a wide array of mammalian hosts (Adam, 2001). The symptoms of Giardiasis include abdominal cramps, nausea, and acute or chronic diarrhea, with malabsorption and failure of children to thrive occurring in both sub-clinical and symptomatic disease (Thompson et al., 1993). Infections are transmitted by cysts which are excreted in the feces of infected humans and animals. Human Giardiasis is distributed worldwide, with rates of detection between 2-5% in the developed world and 20-30% in the developing nations (Farthing, 1994). There is significant variation in the outcome of Giardia infections. Most infections are self-limiting, although re-infection is common in endemic areas and chronic infections also occur. Moreover, some individuals suffer from severe cramps, nausea and diarrhea while others escape these overt symptoms. This review will describe recent advances in parasite genetics and host immunity that are helping to shed light on this variability.
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a meta analysis of the effectiveness of albendazole compared with metronidazole as treatments for infections with giardia duodenalis
PLOS Neglected Tropical Diseases, 2010Co-Authors: Shahram Solaymanimohammadi, Jeanine M Genkinger, Christopher A Loffredo, Steven M SingerAbstract:Background Metronidazole is the most commonly used drug for the treatment of Giardiasis in humans. In spite of its therapeutic efficacy for Giardiasis, low patient compliance, especially in children, side effects, and the emergence of metronidazole-resistant strains may restrict its use. Albendazole has been used to treat Giardia duodenalis infections in recent years. However, efficacy studies in vivo and in vitro have produced diverse results as to its effectiveness. A moderately benign side effect profile, combined with established efficacy against many helminths, renders it promising for treatment of Giardiasis in humans. Methodology and Principal Findings We performed a search in the PubMed, Scopus, EMBASE, the ISI Web of Science, LILIACS, and Cochrane Controlled Trials Register for trials published before February 2010 as well as in references of relevant research and review articles. Eight randomized clinical trials (including 900 patients) comparing the effectiveness of albendazole with that of metronidazole were included in meta-analysis. After extracting and validating the data, the pooled risk ratio (RR) was calculated using an inverse-variance random-effects model. Albendazole was found to be equally as effective as metronidazole in the treatment of Giardiasis in humans (RR 0.97; 95% CI, 0.93, 1.01). In addition, safety analysis suggested that patients treated with albendazole had a lower risk of adverse effects compared with those who received metronidazole (RR 0.36; 95% CI, 0.10, 1.34), but limitations of the sample size precluded a definite conclusion. Conclusions/Significance The effectiveness of albendazole, when given as a single dose of 400 mg/day for 5 days, was comparable to that of metronidazole. Patients treated with albendazole tended to have fewer side effects compared with those who took metronidazole. Given the safety, effectiveness, and low costs of albendazole, this drug could be potentially used as an alternative and/or a replacement for the existing metronidazole therapy protocols in the treatment of Giardiasis in humans.