Opportunistic Infections & Other Complications: Cryptosporidiosis


Opportunistic Infections & Other Complications: Cryptosporidiosis

Seattle Treatment Education Project (STEP) Perspective, Vol. 5, No. 2 - July 1993 * 127 Broadway E. Ste 200 Seattle, WA 98102
Laury McKean, RN

Paromomycin (Humatin) still appears to be the most effective therapy for cryptosporidiosis. In one prospective study, eight individuals received 1500 mg to 2000 mg of paromomycin a day for two to six weeks. Daily stool frequency was reduced by 64% in the treated group and 33% in eight individuals not receiving treatment who served as controls. Oocyst excretion decreased in 88% of the treated group, and 38% of the controls. Additionally, 50% of the treatment group and 38% of the control group ceased to excrete any detectable oocysts (PO-B10-1446). Similar results were reported in other studies (PO-B10-1508, WS-B13-6). Unfortunately, the relapse rate is high. A Canadian study showed initial favorable clinical response in 80% of the 78 indiviuals in their study, with complete microbiological response in 38%. However 58% of the responding individuals relapsed after an average of 2.2 months. In 50% the drug had been tapered or stopped at the time of relapse. Twenty-eight of the participants who relapsed were retreated with paromomycin, but a partial response was reported in only 14 (PO-B10-1473).

A study was also presented assessing the efficacy of azithromycin in the treatment of cryptosporidiosis. Individuals received 600 mg a day for 28 days. In 63 evaluable participants, the frequency of bowel movements was reduced to three or less per day in 48%. A clinical response was seen in 68%. There was a reduction in oocyst counts in approximately 14% of the individuals (PO-B10-1500). Although these results are not overwhelmingly positive, azithromycin may provide clinical benefit in some inidividuals who have no other options. A trial comparing 900 mg of azithromycin to placebo is currently being analyzed.

Another option for individuals with cryptosporidiosis may be letrazuril. Twenty-four individuals who had previously tried paromomycin were treated with 50 mg of letrazuril a day. Four percent experienced a complete response and 50% had a partial clinical response. Microbiological eradication was seen in 44% of the individuals. However, 50% of the responding individuals relapsed after an average of only 1.6 months (PO- B10-1472).
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Copyright © 1993 - Seattle Treatment Education Project (STEP) - All rights reserved. Noncommercial reproduction is encouraged. STEP is published four times a year by the Seattle Treatment Education Project, 127 Broadway East, 3rd Floor, Seattle, WA 98102.    Email: step100@aol.com  STEP web page

This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1993. AEGIS.