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Is paromomycin the drug of choice for eradication of Blastocystis in adults?

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Journal of Infection and Chemotherapy

Abstract

Blastocystis is a protozoan parasite of controversial clinical significance that is often detected in stools of patients with gastrointestinal complaints. Patients infected with Blastocystis and persistent, unexplained gastrointestinal complaints are often treated with the intention to eradicate Blastocystis. However, there is no consensus on the most effective drug. We performed a retrospective follow-up study with a large cohort of patients in which the natural disease course and efficacy of treatment with either paromomycin, clioquinol, or metronidazole were evaluated. With an eradication rate of 77 %, treatment with paromomycin appeared significantly more effective than treatment with clioquinol (38 %), metronidazole (38 %), or no treatment (22 %). This study showed that (1) Blastocystis was frequently observed in the stools of our patient group (34 %), (2) spontaneous clearance of Blastocystis infections occurred only in a small proportion of patients (22 %), and therefore (3) drug treatment is required for more efficient eradication of Blastocystis. Paromomycin exhibited superior performance in comparison to both metronidazole and clioquinol.

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Conflict of interest

The Port of Rotterdam is acknowledged for its financial support of this study.

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Authors and Affiliations

  1. Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre and Harbour Hospital, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands

    Jaap J. van Hellemond

  2. Department of Internal Medicine, Harbour Hospital and Institute for Tropical Diseases, Haringvliet 72, Rotterdam, 3011 TG, The Netherlands

    Nicky Molhoek, Pieter J. Wismans & Perry J. J. van Genderen

  3. Laboratory for Parasitology, Harbour Hospital, Haringvliet 2, Rotterdam, 3011 TD, The Netherlands

    Rob Koelewijn

Authors
  1. Jaap J. van Hellemond
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  2. Nicky Molhoek
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  3. Rob Koelewijn
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  4. Pieter J. Wismans
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  5. Perry J. J. van Genderen
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Corresponding author

Correspondence to Jaap J. van Hellemond.

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van Hellemond, J.J., Molhoek, N., Koelewijn, R. et al. Is paromomycin the drug of choice for eradication of Blastocystis in adults?. J Infect Chemother 19, 545–548 (2013). https://doi.org/10.1007/s10156-012-0496-2

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  • DOI: https://doi.org/10.1007/s10156-012-0496-2

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