TY - CHAP M1 - Book, Section TI - Parasitic Diseases A1 - Cota, Jason M. A1 - Anandan, JV A2 - DiPiro, Joseph T. A2 - Talbert, Robert L. A2 - Yee, Gary C. A2 - Matzke, Gary R. A2 - Wells, Barbara G. A2 - Posey, L. Michael PY - 2017 T2 - Pharmacotherapy: A Pathophysiologic Approach, 10e AB - KEY CONCEPTS Nitazoxanide and tinidazole are Food and Drug Administration (FDA)-approved for giardiasis treatment. While the FDA has not approved metronidazole for this indication, it has been widely accepted as the mainstay of giardiasis therapy for the past 50 years. Human immunodeficiency virus (HIV)-infected patients with cryptosporidiosis must receive antiretroviral therapy as the mainstay of therapy in addition to antiparasitic therapy. Serologic detection assays are required to diagnose Entamoeba histolytica infection because stool sample analysis is insensitive and does not distinguish between E. histolytica and the nonpathogenic E. dispar or E. moshkovskii. Metronidazole and tinidazole are tissue-acting agents against amoeba; whereas, paromomycin, iodoquinol, and diloxanide furoate are luminal amebicides. The drugs that have been used to treat Trypanosoma cruzi infections include benznidazole and nifurtimox, but are not currently approved by the FDA. Both are available from the Centers for Disease Control and Prevention (CDC) under an Investigational New Drug program. Chloroquine has been the recommended drug for malaria chemoprophylaxis, but clinicians have increasingly prescribed alternative antimalarial drugs such as atovaquone-proguanil, doxycycline, primaquine, and mefloquine because these regimens retain effectiveness in areas where chloroquine-resistant Plasmodium falciparum exposure is likely. Administration of corticosteroids or other immunosuppressive drugs to an infected individual can result in hyperinfections and disseminated strongyloidiasis. Antihelminthic therapy destroys parasites and may cause increased inflammation and worsening of neurocysticercosis symptoms. For head lice, the American Academy of Pediatrics recommends either nonprescription 1% permethrin or pyrethrins plus piperonyl butoxide topical preparations as agents of choice unless local resistance to these agents is documented. A single application of 5% permethrin results in cure rates in more than 90% of subjects with scabies at 14 and 28 days, but a second dose should be applied 1 week later because its ovicidal efficacy remains unclear. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1145222320 ER -