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Giardia lamblia
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
The pregnant patient with giardiasis deserves special consideration since the safety of the above agents during pregnancy has not been established. Both quinacrine and metronidazole are known to pass through the placenta into the fetal circulation. Metronidazole has been shown to be carcinogenic in rodents and mutagenic in bacteria, although a tumorigenic effect in humans has not been demonstrated (231). Furazolidone has induced hemolysis in newborns with glucose 6-phosphate deficiency, and its potential for fetal toxicity is unknown. Thus, the use of quinacrine and metronidazole is discouraged during the first trimester, and therapy with furazolidone during pregnancy is con train dicated (232). After the first trimester, quinacrine rather than metronidazole is used by many clinicians, but the benefits of therapy must be weighed carefully against potential effects on the fetus. A poorly absorbed aminoglycoside with antiprotozoal effects, paramomycin, has been used successfully in two pregnant patients with giardiasis (233), but the effectiveness of this agent awaits confirmation.
Furazolidone (Furazolidine)
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Furazolidone is active against a wide range of bacterial and protozoal pathogens, acting by interfering with bacterial and protozoal enzyme systems. Its spectrum of activity includes, but is not limited to, H. pylori, Giardia intestinalis, Blastocystis hominis, Trichomonas species, Escherichia coli, Vibrio cholerae (although the majority of isolates are now resistant), Campylobacter jejuni, Enterobacter aerogenes, Salmonella species, Shigella species, Proteus species, staphylococci, streptococci, and enterococci (Carlson et al., 1983).
Inappropriate treatment in Helicobacter pylori eradication failure: a retrospective study
Published in Scandinavian Journal of Gastroenterology, 2018
Huiyi Li, Xiao Liang, Qi Chen, Wei Zhang, Hong Lu
In all 801 unsuccessful treatment courses, including 1573 courses of antibiotics, were used in these 293 patients. The top four most common antibiotics were clarithromycin (34.4%), levofloxacin (22.7%), metronidazole (18.9%) and amoxicillin (17%). The use of furazolidone, tetracycline and rifampicin was 2.3%, 0.8% and 0.1%, respectively. Gentamicin and cephalosporin were used in 3.2% and 0.5%, respectively. First-line treatments included common antibiotic combinations: a PPI plus clarithromycin–metronidazole (24.6%, 72/293), clarithromycin–levofloxacin (23.5%, 69/293), clarithromycin–amoxicillin (21.5%, 63/293), levofloxacin–metronidazole (7.2%, 21/293), levofloxacin–amoxicillin (6.1%, 18/293) and amoxicillin–metronidazole (3.1%, 9/293) (Table 2). Fifty-eight patients (19.8%) claimed to be hypersensitive to penicillin. Their most common regimens were clarithromycin–levofloxacin (32.8%, 19/58) and clarithromycin–metronidazole (27.6%, 16/58) (Table 3). Even in non-penicillin allergy patients, the first three most common regimens were clarithromycin–amoxicillin (26.8%), clarithromycin–metronidazole (23.8%) and clarithromycin–levofloxacin (21.3%) (Table 4).
Management of antibiotic-resistant Helicobacter pylori infection: current perspective in Iran
Published in Journal of Chemotherapy, 2020
Samin Alihosseini, Reza Ghotaslou, Fatemah Sadeghpour Heravi, Zainab Ahmadian, Hamed Ebrahimzadeh Leylabadlo
The second line therapy is recommended after the failure of first-line treatment.54 The ideal second-line H. pylori eradication regimen is a regimen with more than 80% of PP eradication rate (Table 5).13 In 2001, Sotoudehmanesh et al. investigated the efficacy and tolerability of a furazolidone-based regimen (omeprazole, furazolidone, bismuth, and tetracycline) in 80 patients who experienced an unsuccessful standard metronidazole-based regimen (omeprazole, metronidazole, bismuth, and amoxicillin). They observed a 90% eradication rate with minor side-effects in the second-line regimen. Accordingly, the authors recommended an initial treatment with a furazolidone-based regimen in areas where the metronidazole resistance is high.55
What are the immunopharmacological effects of furazolidone? A systematic review
Published in Immunopharmacology and Immunotoxicology, 2021
Ivan Brito Feitosa, Bruno Mori, Ana Paula de Azevedo dos Santos, Janaína Cecília Oliveira Villanova, Carolina Bioni Garcia Teles, Allyson Guimarães Costa
Furazolidone (FZD) is a synthetic nitrofuran that is used clinically, and is active against a broad spectrum of gram-negative and gram-positive bacteria, as well as against some protozoa. Recent studies have reported that FZD has novel applications in treating leukemia and leishmaniasis [1]. FZD was synthesized in the late 1940s, and it is characterized by the presence of the furan ring in its chemical structure [2]. The chemical structure of FZD comprises two rings, a 5-nitrofuran and a 3-amino-2-oxazolidone ring (AOZ). In bacteria, furazolidone is activated in the first ring by reductive metabolism that is associated with nitroreductases (Figure 1) [3].