Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec:17:128-138.
doi: 10.1016/j.ijpddr.2021.09.001. Epub 2021 Sep 21.

Treatment of human intestinal cryptosporidiosis: A review of published clinical trials

Ajib Diptyanusa  1 , Ika Puspa Sari  2
Affiliations
Review

Treatment of human intestinal cryptosporidiosis: A review of published clinical trials

Ajib Diptyanusa et al. Int J Parasitol Drugs Drug Resist. 2021 Dec.

Abstract

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.

Keywords: Clearance; Clinical trial; Cryptosporidiosis; Cryptosporidium; Drug; Treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Literature search flow.
See this image and copyright information in PMC

References

    1. Abaza B.E., Hamza R.S., Farag T.I., Abdel-Hamid M.A., Moustafa R.A. Assessing the efficacy of nitazoxanide in treatment of cryptosporidiosis using PCR examination. J. Egypt. Soc. Parasitol. 2016;46:683–692. - PubMed
    1. Adeyemo F.E., Singh G., Reddy P., Bux F., Stenström T.A. Efficiency of chlorine and UV in the inactivation of Cryptosporidium and Giardia in wastewater. PloS One. 2019;14 e0216040. - PMC - PubMed
    1. Ahmadpour E., Safarpour H., Xiao L., Zarean M., Hatam-Nahavandi K., Barac A., Picot S., Rahimi M.T., Rubino S., Mahami-Oskouei M., Spotin A., Nami S., Baghi H.B. Cryptosporidiosis in HIV-positive patients and related risk factors: a systematic review and meta-analysis. Parasite. 2020;27 27-27. - PMC - PubMed
    1. Ali S., Kumar S. Treatment outcomes with nitazoxanide in immunocompetent adults naive patients with cryptosporidiosis; do we need combination therapy with paromomycin or azithromycin? Trop Med Surg. 2015;3
    1. Amadi B., Mwiya M., Musuku J., Watuka A., Sianongo S., Ayoub A., Kelly P. Effect of nitazoxanide on morbidity and mortality in Zambian children with cryptosporidiosis: a randomised controlled trial. Lancet. 2002;360:1375–1380. - PubMed