Efficacy of 5-Nitroimidazoles for the Treatment of Giardiasis: A Systematic Review of Randomized Controlled Trials

Background: Giardiasis is one of the most common causes of diarrheal disease worldwide and 5-nitroimidazoles (5-NI) are the most commonly prescribed drugs for the treatment of giardiasis. We evaluated the efficacy of 5-nitroimidazoles (5-NI) in the treatment of giardiasis in a systematic review of r...

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Detalles Bibliográficos
Autores: Pasupuleti, Vinay, Escobedo, Angel Arturo, Deshpande, Abhishek, Thota, Priyaleela, Roman, Yuani, Hernández, Adrian V.
Tipo de recurso: artículo
Fecha de publicación:2014
País:Perú
Institución:Universidad Peruana de Ciencias Aplicadas
Repositorio:UPC-Institucional
Idioma:inglés
OAI Identifier:oai:repositorioacademico.upc.edu.pe:10757/316481
Acceso en línea:https://doi.org/10.1371/journal.pntd.0002733
http://hdl.handle.net/10757/316481
Access Level:acceso abierto
Palabra clave:5-Nitroimidazoles
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dc.title.es_PE.fl_str_mv Efficacy of 5-Nitroimidazoles for the Treatment of Giardiasis: A Systematic Review of Randomized Controlled Trials
title Efficacy of 5-Nitroimidazoles for the Treatment of Giardiasis: A Systematic Review of Randomized Controlled Trials
spellingShingle Efficacy of 5-Nitroimidazoles for the Treatment of Giardiasis: A Systematic Review of Randomized Controlled Trials
Pasupuleti, Vinay
5-Nitroimidazoles
title_short Efficacy of 5-Nitroimidazoles for the Treatment of Giardiasis: A Systematic Review of Randomized Controlled Trials
title_full Efficacy of 5-Nitroimidazoles for the Treatment of Giardiasis: A Systematic Review of Randomized Controlled Trials
title_fullStr Efficacy of 5-Nitroimidazoles for the Treatment of Giardiasis: A Systematic Review of Randomized Controlled Trials
title_full_unstemmed Efficacy of 5-Nitroimidazoles for the Treatment of Giardiasis: A Systematic Review of Randomized Controlled Trials
title_sort Efficacy of 5-Nitroimidazoles for the Treatment of Giardiasis: A Systematic Review of Randomized Controlled Trials
dc.creator.none.fl_str_mv Pasupuleti, Vinay
Escobedo, Angel Arturo
Deshpande, Abhishek
Thota, Priyaleela
Roman, Yuani
Hernández, Adrian V.
author Pasupuleti, Vinay
author_facet Pasupuleti, Vinay
Escobedo, Angel Arturo
Deshpande, Abhishek
Thota, Priyaleela
Roman, Yuani
Hernández, Adrian V.
author_role author
author2 Escobedo, Angel Arturo
Deshpande, Abhishek
Thota, Priyaleela
Roman, Yuani
Hernández, Adrian V.
author2_role author
author
author
author
author
dc.subject.es_PE.fl_str_mv 5-Nitroimidazoles
topic 5-Nitroimidazoles
description Background: Giardiasis is one of the most common causes of diarrheal disease worldwide and 5-nitroimidazoles (5-NI) are the most commonly prescribed drugs for the treatment of giardiasis. We evaluated the efficacy of 5-nitroimidazoles (5-NI) in the treatment of giardiasis in a systematic review of randomized controlled trials (RCTs). Methodology/Principal Findings: We conducted a comprehensive literature search in PubMed-Medline, Scopus, Web of Science and Cochrane Library for RCTs evaluating the efficacy of 5-NI vs. control (placebo or active treatment) on parasitological cure in patients with parasitologically-demonstrated giardiasis. The search was performed in May 2013 with no language restriction by two authors independently. The efficacy outcome was parasitological cure, and harmful outcomes were abdominal pain, bitter or metallic taste, and headache. We included 30 RCTs (n = 3,930). There was a significant and slightly higher response rate with 5-NI in giardiasis treatment (RR 1.06, 95%CI 1.02–1.11, p = 0.005). There was high heterogeneity among studies (I2= 72%). The response rates for metronidazole, tinidazole and secnidazole were similar (RR 1.05, 95%CI 1.01–1.09, p = 0.01; RR 1.32 95%CI 1.10–1.59, p = 0.003; and RR 1.18 95%CI 0.93–1.449, p = 0.18, respectively). On subgroup analyses, the response rates did not vary substantially and high heterogeneity persisted (I2= 57%–80%). Harmful outcomes were uncommon, and 5-NIs were associated with lower risk of abdominal pain, and higher risk of both bitter or metallic taste and headache. Conclusions: Studies investigating the efficacy of 5-NI in giardiasis treatment are highly heterogeneous. 5-NIs have a slightly better efficacy and worse profile for mild harmful outcomes in the treatment of giardiasis in comparison to controls. Larger high quality RCTs are needed to further assess efficacy and safety profiles of 5-NI.
publishDate 2014
dc.date.accessioned.none.fl_str_mv 2014-05-03T20:51:54Z
dc.date.available.none.fl_str_mv 2014-05-03T20:51:54Z
dc.date.issued.fl_str_mv 2014-05-03
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dc.identifier.citation.es_PE.fl_str_mv PLoS Negl Trop Dis 8(3): e2733
dc.identifier.doi.none.fl_str_mv https://doi.org/10.1371/journal.pntd.0002733
dc.identifier.uri.es_PE.fl_str_mv http://hdl.handle.net/10757/316481
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dc.identifier.journal.es_PE.fl_str_mv PLOS Neglected Tropical Diseases
identifier_str_mv PLoS Negl Trop Dis 8(3): e2733
1932-6203
PLOS Neglected Tropical Diseases
url https://doi.org/10.1371/journal.pntd.0002733
http://hdl.handle.net/10757/316481
dc.language.iso.es_PE.fl_str_mv eng
language eng
dc.relation.url.es_PE.fl_str_mv http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0002733
dc.rights.es_PE.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.es_PE.fl_str_mv Public Library of Science (PLoS)
dc.source.es_PE.fl_str_mv Universidad Peruana de Ciencias Aplicadas (UPC)
Repositorio Académico - UPC
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spelling 035ccb14f2f341b78fc375787881abaf-1efb96549813456fe4d904ce61bc585dd-17d82c5b598ef68a93a813fae0b170f93-15e2d243ff3d30434d33ba81e01455ba7-1c2ae87841f8397a5c91207202b5fc72c-1df1954be75757918c00849433ed0d14a-12014-05-03T20:51:54Z2014-05-03T20:51:54Z2014-05-03PLoS Negl Trop Dis 8(3): e2733https://doi.org/10.1371/journal.pntd.0002733http://hdl.handle.net/10757/3164811932-6203PLOS Neglected Tropical DiseasesBackground: Giardiasis is one of the most common causes of diarrheal disease worldwide and 5-nitroimidazoles (5-NI) are the most commonly prescribed drugs for the treatment of giardiasis. We evaluated the efficacy of 5-nitroimidazoles (5-NI) in the treatment of giardiasis in a systematic review of randomized controlled trials (RCTs). Methodology/Principal Findings: We conducted a comprehensive literature search in PubMed-Medline, Scopus, Web of Science and Cochrane Library for RCTs evaluating the efficacy of 5-NI vs. control (placebo or active treatment) on parasitological cure in patients with parasitologically-demonstrated giardiasis. The search was performed in May 2013 with no language restriction by two authors independently. The efficacy outcome was parasitological cure, and harmful outcomes were abdominal pain, bitter or metallic taste, and headache. We included 30 RCTs (n = 3,930). There was a significant and slightly higher response rate with 5-NI in giardiasis treatment (RR 1.06, 95%CI 1.02–1.11, p = 0.005). There was high heterogeneity among studies (I2= 72%). The response rates for metronidazole, tinidazole and secnidazole were similar (RR 1.05, 95%CI 1.01–1.09, p = 0.01; RR 1.32 95%CI 1.10–1.59, p = 0.003; and RR 1.18 95%CI 0.93–1.449, p = 0.18, respectively). On subgroup analyses, the response rates did not vary substantially and high heterogeneity persisted (I2= 57%–80%). Harmful outcomes were uncommon, and 5-NIs were associated with lower risk of abdominal pain, and higher risk of both bitter or metallic taste and headache. Conclusions: Studies investigating the efficacy of 5-NI in giardiasis treatment are highly heterogeneous. 5-NIs have a slightly better efficacy and worse profile for mild harmful outcomes in the treatment of giardiasis in comparison to controls. Larger high quality RCTs are needed to further assess efficacy and safety profiles of 5-NI.Revisión por paresapplication/pdfengPublic Library of Science (PLoS)http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0002733info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/4.0/Universidad Peruana de Ciencias Aplicadas (UPC)Repositorio Académico - UPCreponame:UPC-Institucionalinstname:Universidad Peruana de Ciencias Aplicadasinstacron:UPC5-NitroimidazolesEfficacy of 5-Nitroimidazoles for the Treatment of Giardiasis: A Systematic Review of Randomized Controlled Trialsinfo:eu-repo/semantics/articlehttp://purl.org/coar/version/c_970fb48d4fbd8a130Articulo científicoPasupuleti, VinayEscobedo, Angel ArturoDeshpande, AbhishekThota, PriyaleelaRoman, YuaniHernández, Adrian V.2018-06-16T16:22:16ZBackground: Giardiasis is one of the most common causes of diarrheal disease worldwide and 5-nitroimidazoles (5-NI) are the most commonly prescribed drugs for the treatment of giardiasis. We evaluated the efficacy of 5-nitroimidazoles (5-NI) in the treatment of giardiasis in a systematic review of randomized controlled trials (RCTs). Methodology/Principal Findings: We conducted a comprehensive literature search in PubMed-Medline, Scopus, Web of Science and Cochrane Library for RCTs evaluating the efficacy of 5-NI vs. control (placebo or active treatment) on parasitological cure in patients with parasitologically-demonstrated giardiasis. The search was performed in May 2013 with no language restriction by two authors independently. The efficacy outcome was parasitological cure, and harmful outcomes were abdominal pain, bitter or metallic taste, and headache. We included 30 RCTs (n = 3,930). There was a significant and slightly higher response rate with 5-NI in giardiasis treatment (RR 1.06, 95%CI 1.02–1.11, p = 0.005). There was high heterogeneity among studies (I2= 72%). The response rates for metronidazole, tinidazole and secnidazole were similar (RR 1.05, 95%CI 1.01–1.09, p = 0.01; RR 1.32 95%CI 1.10–1.59, p = 0.003; and RR 1.18 95%CI 0.93–1.449, p = 0.18, respectively). On subgroup analyses, the response rates did not vary substantially and high heterogeneity persisted (I2= 57%–80%). Harmful outcomes were uncommon, and 5-NIs were associated with lower risk of abdominal pain, and higher risk of both bitter or metallic taste and headache. Conclusions: Studies investigating the efficacy of 5-NI in giardiasis treatment are highly heterogeneous. 5-NIs have a slightly better efficacy and worse profile for mild harmful outcomes in the treatment of giardiasis in comparison to controls. 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