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info needed

ctfaulkn at utkvx.utk.edu ctfaulkn at utkvx.utk.edu
Wed May 10 22:25:40 EST 1995

In Article <Pine.SOL.3.91.950510202233.9086A-100000 at welchlink.welch.jhu.edu>
"CHRISTOPHER V. PLOWE" <cplowe at welchlink.welch.jhu.edu> writes:
>Praziquantel is not used to treat giardiasis, nor is albendazole.  Just 
>because someone has reported something in the scientific literature 
>doesn't mean it is safe or effective. 

	Perhaps you may be interested in a couple of papers by Barr et al
(Am Jour Vet Res 54: 926-928, Am Jour Vet Res 55:988-990).  While it is true
that Praziquantel is not used to treat Giardia, there is some pretty good
evidence for efficacy of Albendazole, and Fenbendazole in treating Giardia.
Metronitazole is only approx 67% effective, and has been associated with
neurotoxicity, is expensive, and is suspected of being teratogenic. 
Additionaly, it is poorly tolerated and efficacy falls below the 67% if the
patient suspends treatment when the diarrhea goes away.  There is no current 
label indication on Albendazole as a giardiacide, so use of the drug would
have to be at the physician's discretion.   These broad spectrum anthelmintics
may be useful in 3rd world countries where infections with Giardia, Trichuris,
and Ascaris commonly occur together.  Although Albendazole is contraindicated
for pregnant and lactating women, I have heard there is interest in getting
human appproval for Fenbendazole, primarily as a giardiacide.   This drug is 
safe, and will be approved for dairy usage soon so it should be safe for 
lactating women. 

>Also, diagnosis of giardiasis or any disease requires a proper history, 
>physical exam and laboratory tests.  Speculation based on a brief message 
>is totally unreliable.

	Your comments about giving medical advice are right on target.
It is important to keep in mind that parasitologists are not medical
practioners, unless they also have an MD.  However, parasitologists can be
important sources of information for lifecycle biology, mode of transmission, 
epidemiology, and sometimes even treatment given our familiarity with the 
current literature.  Any information given over the net should be done with 
the recognition that all management of a 'suspected' case of parasitism is
carried out in a patient/physician context, and one doesn't run to Walgreens
for a bottle of Vermox.

*      Charles T. Faulkner       *   Get your facts first and then you
*  Univ of Tennessee, Knoxville  *   can distort them as much as you please.
*   (ctfaulkn at utkvx.utk.edu)     *                   Mark Twain

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