The old and new therapeutic approaches to the treatment of giardiasis: Where are we?

Biologics: Targets and Therapy

Volumn 3, Issue , 2009, Pages 273-287

  Busatti, Haendel G N O ^a   Santos, Joseph F G ^b   Gomes, Maria A ^a  

^a FEDERAL UNIVERSITY OF MINAS GERAIS   (Brazil)

^b Santa Casa de Misericórdia de Belo Horizonte Hospital   (Brazil)

Author keywords

Giardia lamblia; New drugs; Treatment

Indexed keywords

EID: 84886112738     PISSN: 11775475     EISSN: 11775491     Source Type: Journal    
DOI: 10.2147/BTT.S3943     Document Type: Review

References (151)

1. Meyer EA, Radulescu S. Giardia and Giardiasis. Adv Parasitol. 1979;17:1-47.
2. Ungar BLP, Yolken RH, Nash TE, et al. Enzyme-linked immunosorbent assay for the detection of Giardia lamblia in fecal specimens. J Infect Dis. 1984;149(1):90-97.
3. Goldin AJ, Werner APT, Aguilera X, et al. Efficient diagnosis of giardiasis among nursery and primary school children in Santiago, Chile by capture ELISA for the detection of fecal Giardia antigens. Am J Trop Med Hyg. 1990;42(6):538-545.
4. Farthing MJG. Host parasite interactions in human Giardiasis. Quart J Med. 1989;70(263):191-204.
5. Thompson RCA, Reynoldson JA, Mendis AHW. Giardia and Giardiasis. Adv Parasitol. 1993;32:71-160.
6. Fayer R. Cryptosporidium: a water-borne zoonotic parasite. Vet Parasitol. 2004;126(1-2):37-56.
7. Thompson RC. The zoonotic significance and molecular epidemiology of Giardia and giardiasis. Vet Parasitol. 2004;126(1-2):15-35.
8. Rendtorff RC. The experimental transmission of human intestinal protozoan parasites II. Giardia lamblia cysts given in capsules. Am J Hyg. 1954;59(2):209-220.
9. Hunter PR, Thompson RC. The zoonotic transmission of Giardia and Cryptosporidium. Int J Parasitol. 2005;35(11-12):1181-1190.
10. Ungar BLP, Yolken RH, Nash TE, et al. Enzyme-linked immunosorbent assay for the detection of Giardia lamblia in fecal specimens. J Infect Dis. 1984;149(1):90-97.
11. Lane S, Lloyd D. Current trends in research into the waterborne parasite Giardia. Crit Rev Microbiol. 2002;28(2):123-147.
12. World Health Organization. The World Health Report 1996. Fighting Disease Fostering Development. Geneva, Switzerland: World Health Organization; 1996.
13. Thompson RCA, Lymbery AJ, Meloni BP. Genetic variation in Giardia Kunstler, 1882: taxonomic and epidemiological significance. Protozool Abstracts. 1990;14:1-28.
14. Wright JM, Dunn LA, Upcroft P, et al. Efficay of antigiardial drugs. Expert Opin Drug Saf. 2003;2:529-541.
15. Johnson PJ. Metronidazole and drug resistance. Parasitol Today. 1993;9(5):183-186.
16. Upcroft JA, Dunn LA, Wright JM, et al. 5-Nitroimidazole drugs effective against metronidazole-resistant Trichomonas vaginalis and Giardia duodenalis. Antimicrob Agents Chemother. 2006;50(1):344-347.
17. Long KZ, Rosado JL, Montoya Y, et al. Effect of vitamin A and zinc supplementation on gastrointestinal parasitic infections among Mexican children. Pediatrics. 2007;120(4):846-855.
18. Ellis JE, Wingfield JM, Cole D, et al. Oxygen affinities of metronidazoleresistant and-sensitive stocks of Giardia intestinalis. Int J Parasitol. 1993;23(1):35-39.
19. Upcroft JA, Campbell RW, Benakli K, et al. Efficacy of new 5-nitroimidazoles against metronidazole-susceptible and resistant Giardia, Trichomonas, and Entamoeba spp. Antimicrob Agents Chemother. 1999;43(1):73-76.
20. Petri W. Therapy of intestinal protozoa. Trends Parasitol. 2003;19(11): 523-526.
21. Boreham PFL, Phillips RE, Shepherd RW. Altered uptake of metronidazole in vitro by stocks of Giardia intestinalis with different drug sensitivities. Trans R Soc Trop Med Hyg. 1988;82(1):104-106.
22. Upcroft JA, Upcroft P, Boreham PFL. Drug resistance in Giardia intestinalis. Int J Parasitol. 1990;20(4):489-496.
23. Melloni P, Metelli R, Bassini DF, et al. Snythesis and antiprotozoal activity of nitro derivatives of 2, 2'-biimidazole. Arzneimittelforschung. 1975;25(1):9-14.
24. Gillin FD, Reiner DS, Wang CS. Human milk kills parasitic intestinal protozoa. Science. 1983;221(4617):1290-1292.
25. Takeuchi T, Kobayashi S, Tanabe M, et al. In vitro inhibition of Giardia lamblia and Trichomonas vaginalis growth by bithionol, dichlorophene, and hexachlorophene. Antimicrob Agents Chemother. 1985;27(1):65-70.
26. Weinbach EC, Costa JL, Wieder SC. Antidepressant drugs suppress growth of the human pathogenic protozoan Giardia lamblia. Res Commun Chem Pathol Pharmacol. 1985;47(1):145-148.
27. McIntyre P, Boreham PF, Phillips RE, et al. Chemotherapy in giardiasis: clinical responses and in vitro drug sensitivity of human isolates in axenic culture. J Pediatr. 1986;108(6):1005-1010.
28. Crouch AA, Seow WK, Whitman LM, et al. Sensitivity in vitro of Giardia intestinalis to dyadic combinations of azithromycin, doxycycline, mefloquine, tinidazole and furazolidone. Trans R Soc Trop Med Hyg. 1990;84(2):246-248.
29. Majewska AC, Kasprzak W, De Jonckheere JF, et al. Heterogeneity in the sensitivity of stocks and clones of Giardia to metronidazole and ornidazole. Trans R Soc Trop Med Hyg. 1991;85(1):67-69.
30. Boreham PFL, Upcroft JA. The activity of azithromycin against stocks of Giardia intestinalis in vitro and in vivo. Trans R Soc Trop Med Hyg. 1991;85(5):620-621.
31. Belosevic M, Faubert GM, Dharampaul S. Antimicrobial action of antibodies against Giardia muris trophozoites. Clin Exp Immunol. 1994;95(3):485-489.
32. Ortega-Barria E, Ward HD, Keusch GT, et al. Growth inhibition of the intestinal parasite Giardia lamblia by a dietary lectin is associated with arrest of the cell cycle. J Clin Invest. 1994;94(6):2283-2288.
33. Johns T, Faubert GM, Kokwaro JO, et al. Anti-giardial activity of gastrointestinal remedies of the Luo of east Africa. J Ethnopharmacol. 1995;46(1):17-23.
34. Farbey MD, Reynoldson JA, Thompson RC. In vitro drug susceptibility of 29 isolates of Giardia intestinalis from humans as assessed by anadhesion assay. Int J Parasitol. 1995;25(5):593-599.
35. Campanati L, Gadelha AP, Monteiro-Leal LH. Electron and videolight microscopy analysis of the in vitro effects of pyrantel pamoate on Giardia lamblia. Exp Parasitol. 2001;97(1):9-14.
36. McAllister TA, Annett CB, Cockwill CL, et al. Studies on the use of Yucca schidigera to control giardiasis. Vet Parasitol. 2001;97(2):85-99.
37. Sousa MC, Poiares-da-Silva J. The cytotoxic effects of ciprofloxacin in Giardia lamblia trophozoites. Toxicol In Vitro. 2001;15(4-5): 297-301.
38. Cedillo-Rivera R, Chávez B, González-Robles A, et al. In vitro effect of nitazoxanide against Entamoeba histolytica, Giardia intestinalis and Trichomonas vaginalis trophozoites. J Eukaryot Microbiol. 2002;49(3):201-208.
39. Roskens H, Erlandsen SL. Inhibition of in vitro attachment of Giardia trophozoites by mucin. J Parasitol. 2002;88(5):869-873.
40. Mineno T, Stanford KM, Walker LA, et al. Solution-phase parallel synthesis of an isoflavone library for the discovery of novel antigiardial agents. Comb Chem High Throughput Screen. 2002;5(6):481-487.
41. Jiménez-Cardoso E, Flores-Luna A, Angeles E, et al. In vitro antigiardial activity of IRE-6A and IRE-7B, two ethyl-phenylcarbamate derivatives. Rev Invest Clin. 2003;55(4):444-447.
42. Suh M, Belosevic M, Clandinin MT. Dietary lipids containing gangliosides reduce Giardia muris infection in vivo and survival of Giardia lamblia trophozoites in vitro. Parasitology. 2004;128(Pt 6):595-602.
43. Jiménez-Cardoso E, Flores-Luna A, Pérez-Urizar J. In vitro activity of two phenyl-carbamate derivatives, singly and in combination with albendazole against albendazole-resistant Giardia intestinalis. Acta Trop. 2004;92(3):237-244.
44. Rayan P, Stenzel D, McDonnell PA. The effects of saturated fatty acids on Giardia duodenalis trophozoites in vitro. Parasitol Res. 2005;97(3):191-200.
45. Escudero-Lourdes C, Martínez FD, Medina de la Garza CE, et al. Effect of oral chronic intoxication with sodium arsenite on murine giardiasis. Proc West Pharmacol Soc. 2005;48:92-99.
46. Navarrete-Vázquez G, Rojano-Vilchis Mde M, Yépez-Mulia L, et al. Synthesis and antiprotozoal activity of some 2-(trifluoromethyl)-1Hbenzimidazole bioisosteres. Eur J Med Chem. 2006;41(1):135-141.
47. Müller J, Rühle G, Müller N, et al. In vitro effects of thiazolides on Giardia lamblia WB clone C6 cultured axenically and in coculture with Caco2 cells. Antimicrob Agents Chemother. 2006;50(1):162-170.
48. Shinohara L, de Freitas SF, da Silva RJ, et al. In vitro effects of Crotalus durissus terrificus and Bothrops jararaca venoms on Giardia duodenalis trophozoites. Parasitol Res. 2006;98(4):339-344.
49. Freitas SF, Shinohara L, Sforcin JM, et al. In vitro effects of propolis on Giardia duodenalis trophozoites. Phytomedicine. 2006;13(3): 170-175.
50. Pérez-Arriaga L, Mendoza-Magaña ML, Cortés-Zárate R, et al. Cytotoxic effect of curcumin on Giardia lamblia trophozoites. Acta Trop. 2006;98(2):152-161.
51. Busatti HGNO, Vieira AED, Viana JC, et al. Effect of metronidazole analogues on Giardia lamblia cultures. Parasitol Res. 2007;102(1):145-149.
52. Anthony JP, Fyfe L, Stewart D, McDougall GJ, Smith HV. The effect of blueberry extracts on Giardia duodenalis viability and spontaneous excystation of Cryptosporidium parvum oocysts, in vitro. Methods. 2007;42(4):339-348.
53. Calzada F, Alanís AD. Additional antiprotozoal flavonol glycosides of the aerial parts of Helianthemum glomeratum. Phytother Res. 2007;21(1):78-80.
54. Calzada F, Yépez-Mulia L, Aguilar A. In vitro susceptibility of Entamoeba histolytica and Giardia lamblia to plants used in Mexican traditional medicine for the treatment of gastrointestinal disorders. J Ethnopharmacol. 2006;108(3):367-370.
55. Hausen MA, Freitas JC Jr, Monteiro-Leal LH. The effects of metronidazole and furazolidone during Giardia differentiation into cysts. Exp Parasitol. 2006;113(3):135-141.
56. Calzada F. Additional antiprotozoal constituents from Cuphea pinetorum, a plant used in Mayan traditional medicine to treat diarrhoea. Phytother Res. 2005;19(8):725-727.
57. Said Fernández S, Ramos Guerra MC, Mata Cárdenas BD, et al. In vitro antiprotozoal activity of the leaves of Artemisia ludoviciana. Fitoterapia. 2005;76(5):466-468.
58. Andrzejewska M, Yepez-Mulia L, Tapia A, et al. Synthesis, and antiprotozoal and antibacterial activities of S-substituted 4,6-dibromoand 4,6-dichloro-2-mercaptobenzimidazoles. Eur J Pharm Sci. 2004;21(2-3):323-329.
59. Meckes M, Calzada F, Tapia-Contreras A, et al. Antiprotozoal properties of Helianthemum glomeratum. Phytother Res. 1999;13(2):102-105.
60. Lun ZR, Burri C, Menzinger M, et al. Antiparasitic activity of diallyl trisulfide (Dasuansu) on human and animal pathogenic protozoa (Trypanosoma sp., Entamoeba histolytica and Giardia lamblia) in vitro. Ann Soc Belg Med Trop. 1994;74(1):51-59.
61. Boreham PFL, Phillips RE, Shepherd RW. The sensitivity of Giardia intestinalis to drugs in vitro. J Antimicrob Chemother. 1984;14(5):449-461.
62. Reynoldson JA, Thompson RC, Meloni BP. In vivo efficacy of albendazole against Giardia duodenalis in mice. Parasitol Res. 1991;77(4):325-328.
63. Bhopale KK, Pradhan KS, Phaltankar PG, et al. Activity of a new oxadiazole compound, against experimental infections with Entamoeba histolytica and Giardia lamblia in animal models. Ann Trop Med Parasitol. 1993;87(2):169-178.
64. Wahl SM, Gilman RH, O'Hare J, et al. A new miniculture technique for determining in vitro antimicrobial agent sensitivity of axenically cultivated strains of Giardia lamblia. In: Hammond BR, Wallis PM, editors. Advances in Giardia Research. Calgary, Canada: University of Calgary Press; 1988. p. 21-24.
65. Nash T, Rice WG. Efficacies of zinc-finger-active drugs against Giardia lamblia. Antimicrob Agents Chemother. 1998;42(6):1488-1492.
66. Villeneuve V, Beugnet F, Bourdoiseau G. Efficacy of oxfendazole for the treatment of giardiosis in dogs. Experiments in dog breeding kennels. Parasite. 2000;7(3):221-226.
67. Hassan SI, Nessim NG, Mahmoud SS, et al. Effect of a broad spectrum antiparasitic drug "ivermectin" in acute and chronic experimental giardiasis using different dose regimens. J Egypt Soc Parasitol. 2001;31(2):419-428.
68. Langford TD, Housley MP, Boes M, et al. Central importance of immunoglobulin A in host defense against Giardia spp. Infect Immun. 2002;70(1):11-18.
69. Stein JE, Radecki SV, Lappin MR. Efficacy of Giardia vaccination in the treatment of giardiasis in cats. J Am Vet Med Assoc. 2003;222(11): 1548-1551.
70. El-Taweel HA, El-Zawawy LA, Said DE, et al. Influence of the antioxidant drug (Antox) on experimental giardiasis and microsporidiosis. J Egypt Soc Parasitol. 2007;37(1):189-204.
71. Choudhry VP, Sabir M, Bhide VN. Berberine in giardiasis. Indian Pediatr. 1972;9(3):143-146.
72. Gupte S. Use of berberine in treatment of giardiasis. Am J Dis Child. 1975;129(7):866.
73. Levi GC, Avila CA, Neto VA. Efficay of various drugs for treatment of giardiasis. A comparative study. Am J Trop Med Hyg. 1977;26(3): 564-565.
74. Iyngkaran N, Lee IL, Robinson MJ. Single dose treatment with Tiberal of Giardia lamblia infection in children. Scand J Infect Dis. 1978;10(3):243-246.
75. Jokipii L, Jokipii AM. Comparison of four dosage schedules in the treatment of giardiasis with metronidazole. Infection. 1978;6(2):92-94.
76. Gazder AJ, Banerjee M. Single dose therapy of giardiasis with tinidazole and metronidazole. Drugs. 1978;15 suppl 1:30-32.
77. Farahmandian I, Sheiban F, Sanati A. Evaluation of the effect of a single dose of tinidazole (Fasigyn) in giardiasis. J Trop Med Hyg. 1978;81(7):139-140.
78. Jokipii AM, Jokipii L. Comparative evaluation of two dosages of tinidazole in the treatment of giardiasis. Am J Trop Med Hyg. 1978;27(4):758-761.
79. Kavousi S. Giardiasis in infancy and childhood: a prospective study of 160 cases with comparison of quinacrine (Atabrine) and metronidazole (Flagyl). Am J Trop Med Hyg. 1979;28(1):19-23.
80. Werkman HP, Meuwissen JH. Single-dose treatment of giardiasis with ornidazole in children. Lancet. 1979;2(8156-8157):1373.
81. Sabchareon A, Chongsuphajaisiddhi T, Attanath P. Treatment of giardiasis in children with quinacrine, metronidazole, tinidazole and ornidazole. Southeast Asian J Trop Med Public Health. 1980;11(2):280-284.
82. Craft JC, Murphy T, Nelson JD. Furazolidone and quinacrine. Comparative study of therapy for giardiasis in children. Am J Dis Child. 1981;135(2):164-166.
83. Bassily S, Farid Z, el-Masry NA, et al. Treatment of intestinal E. histolytica and G. lamblia with metronidazole, tinidazole and ornidazole: a comparative study. J Trop Med Hyg. 1987;90(1):9-12.
84. Cervetto JL, Ramonet M, Nahmod LH, et al. Giardiasis. Functional, immunological and histological study of the small bowel. Therapeutic trial with a single dose of tinidazole. Arq Gastroenterol. 1987;24(2):102-112.
85. Nikolić A, Durković-Daković O, Petrović Z, et al. Effects of age-targeted treatment of intestinal parasite infections in Serbia. J Chemother. 1995;7(1):55-57.
86. Qureshi H, Ali A, Baqai R, et al. Efficacy of a combined diloxanide furoate-metronidazole preparation in the treatment of amoebiasis and giardiasis. J Int Med Res. 1997;25(3):167-170.
87. Agarwal AK, Tripathi DM, Sahai R, et al. Management of giardiasis by a herbal drug 'Pippali Rasayana': a clinical study. J Ethnopharmacol. 1997;56(3):233-236.
88. Penggabean M, Norhayati, Oothuman P, et al. Efficacy of albendazole in the treatment of Trichuris trichuria and Giardia intestinalis infection in rural Malay communities. Med J Malaysia. 1998;53(4):408-412.
89. Qureshi H, Baqai R, Mehdi I, et al. Secnidazole response in amoebiasis and giardiasis. East Mediterr Health J. 1999;5(2):389-390.
90. Di Prisco MC, Jiménez JC, Rodríguez N, et al. Clinical trial with secnidazole in a single dose in Venezuelan children infected by Giardia intestinalis. Invest Clin. 2000;41(3):179-188.
91. Monajemzadeh SM, Monajemzadeh M. Comparison of iron and hematological indices in Giardia lamblia infection before and after treatment in 102 children in Ahwaz, Iran. Med Sci Monit. 2008;14(1):19-23.
92. Bassily S, Farid Z, Mikhail JW, et al. The treatment of Giardia lamblia infection with mepacrine, metronidazole and furazolidone. J Trop Med Hyg. 1970;73(1):15-18.
93. Gazder AJ, Banerjee M. Single-dose treatment of giardiasis in children: a comparison of tinidazole and metronidazole. Curr Med Res Opin. 1977;5(2):164-168.
94. Krishnamurthy KA, Saradhambal V. Single dose therapy of giardiasis: a comparative study of tinidazole and metronidazole in pediatric patients. Indian Pediatr. 1978;15(1):51-56.
95. Masry NA, Farid Z, Miner WF. Treatment of giardiasis with tinidazole. Am J Trop Med Hyg. 1978;27(1 Pt 1):201-202.
96. Kyrönseppä H, Pettersson T. Treatment of giardiasis: relative efficacy of metronidazole as compared with tinidazole. Scand J Infect Dis. 1981;13(4):311-312.
97. Speelman P. Single-dose tinidazole for the treatment of giardiasis. Antimicrob Agents Chemother. 1985;27(2):227-229.
98. Okhuysen PC, DuPont HL, Flores Lopez JF, et al. A comparative study of furazolidone and placebo in addition to oral rehydration in the treatment of acute infantile diarrhea. Scand J Gastroenterol Suppl. 1989;169:39-46.
99. Quiros-Buelna E. Furazolidone and metronidazole for treatment of giardiasis in children. Scand J Gastroenterol Suppl. 1989;169:65-69.
100. Gascon J, Moreno A, Valls ME, et al. Failure of mebendazole treatment in Giardia lamblia infection. Trans R Soc Trop Med Hyg. 1989;83(5):647.
101. Gascon J, Abós R, Valls ME, et al. Mebendazole and metronidazole in giardial infections. Trans R Soc Trop Med Hyg. 1990;84(5):694.
102. Oren B, Schgurensky E, Ephros M, et al. Single-dose ornidazole versus seven-day metronidazole therapy of giardiasis in Kibbutzim children in Israel. Eur J Clin Microbiol Infect Dis. 1991;10(11):963-965.
103. al-Waili NS, Hasan NU. Mebendazole in giardial infection: a comparative study with metronidazole. J Infect Dis. 1992;165(6):1170-1171.
104. Dutta AK, Phadke MA, Bagade AC, et al. A randomised multicentre study to compare the safety and efficacy of albendazole and metronidazole in the treatment of giardiasis in children. Indian J Pediatr. 1994;61(6): 689-693.
105. Misra PK, Kumar A, Agarwal V, et al. A comparative clinical trial of albendazole versus metronidazole in giardiasis. Indian Pediatr. 1995;32(3):291-294.
106. Andrews BJ, Panitescu D, Jipa GH, et al. Chemotherapy for giardiasis: randomized clinical trial of bacitracin, bacitracin zinc, and a combination of bacitracin zinc with neomycin. Am J Trop Med Hyg. 1995;52(4):318-321.
107. Misra PK, Kumar A, Agarwal V, et al. A comparative clinical trial of albendazole versus metronidazole in children with giardiasis. Indian Pediatr. 1995;32(7):779-782.
108. Bulut BU, Gülnar SB, Aysev D. Alternative treatment protocols in giardiasis: a pilot study. Scand J Infect Dis. 1996;28(5):493-495.
109. Pengsaa K, Sirivichayakul C, Pojjaroen-anant C, et al. Albendazole treatment for Giardia intestinalis infections in school children. Southeast Asian J Trop Med Public Health. 1999;30(1):78-83.
110. Sadjjadi SM, Alborzi AW, Mostovfi H. Comparative clinical trial of mebendazole and metronidazole in giardiasis of children. J Trop Pediatr. 2001;47(3):176-178.
111. Rossignol JF, Ayoub A, Ayers MS. Treatment of diarrhea caused by Giardia intestinalis and Entamoeba histolytica or E. dispar: a randomized, double-blind, placebo-controlled study of nitazoxanide. J Infect Dis. 2001;184(3):381-384.
112. Ortiz JJ, Ayoub A, Gargala G, et al. Randomized clinical study of nitazoxanide compared to metronidazole in the treatment of symptomatic giardiasis in children from Northern Peru. Aliment Pharmacol Ther. 2001;15(9):1409-1415.
113. Grant J, Mahanty S, Khadir A. Wheat germ supplement reduces cyst and trophozoite passage in people with giardiasis. Am J Trop Med Hyg. 2001;65(6):705-710.
114. Pengsaa K, Limkittikul K, Pojjaroen-anant C. Single-dose therapy for giardiasis in school-age children. Southeast Asian J Trop Med Public Health. 2002;33(4):711-717.
115. Ozbilgin A, Ertan P, Yereli K, et al. Giardiasis treatment in Turkish children with a single dose of ornidazole. Scand J Infect Dis. 2002;34(12): 918-920.
116. Escobedo AA, Cañete R, Gonzalez ME, et al. A randomized trial comparing mebendazole and secnidazole for the treatment of giardiasis. Ann Trop Med Parasitol. 2003;97(5):499-504.
117. Escobedo AA, Núñez FA, Moreira I, et al. Comparison of chloroquine, albendazole and tinidazole in the treatment of children with giardiasis. Ann Trop Med Parasitol. 2003;97(4):367-371.
118. Karabay O, Tamer A, Gunduz H et al. Albendazole versus metronidazole treatment of adult giardiasis: An open randomized clinical study. World J Gastroenterol. 2004;10(8):1215-1217.
119. Yereli K, Balciolu IC, Ertan P, et al. Albendazole as an alternative therapeutic agent for childhood giardiasis in Turkey. Clin Microbiol Infect. 2004;10(6):527-529.
120. Besirbellioglu BA, Ulcay A, Can M, et al. Saccharomyces boulardii and infection due to Giardia lamblia. Scand J Infect Dis. 2006;38 (6-7):479-481.
121. Canete R, Escobedo AA, Gonzalez ME, et al. Randomized clinical study of five days apostrophe therapy with mebendazole compared to quinacrine in the treatment of symptomatic giardiasis in children. World J Gastroenterol. 2006;12(39):6366-6370.
122. Cañete R, Escobedo AA, González ME, et al. A randomized, controlled, open-label trial of a single day of mebendazole versus a single dose of tinidazole in the treatment of giardiasis in children. Curr Med Res Opin. 2006;22(11):2131-2136.
123. Alizadeh A, Ranjbar M, Kashani KM, et al. Albendazole versus metronidazole in the treatment of patients with giardiasis in the Islamic Republic of Iran. East Mediterr Health J. 2006;12(5):548-554.
124. Lindquist HD. Induction of albendazole resistance in Giardia lamblia. Microb Drug Resist. 1996;2(4):433-434.
125. El-Taweel HA, El-Zawawy LA, Said DE, et al. Influence of the antioxidant drug (Antox) on experimental giardiasis and microsporidiosis. J Egypt Soc Parasitol. 2007;37(1):189-204.
126. Maeda K, Osato T, Umeza H. A new antibiotic: Azomycin. J Antibiot. 1953;6A:182.
127. Cosar C, Julou L. Activitc de 1'(hydroxy-2-ethyl)-1-methyl-2-nitro-5-imidazole (8,823 RP) vis-à-vis des infections experimentales Trichomonas vaginalis. Ann Inst Pasteur. 1959;96:238-241.
128. Darbon A, Portal A, Girier L, et al. Treatment of giardiasis (lambliasis) with metronidazole. Presse Med. 1962;70:15-16.
129. Gardner TB, Hill DR. Treatment of Giardiasis. Clin Microbiol Rev. 2001;14(1):114-128.
130. Boreham PFL, Phillips RE, Shepherd RW. The sensitivity of Giardia intestinalis to drugs in vitro. J Antimicrob Chemother. 1984;14(5): 449-461.
131. Wright CW, Melwani SI, Phillipson JD, et al. Determination of antigiardial activity in vitro by mean of soluble formazan production. Trans R Soc Trop Med Hyg. 1992;86(5):517-519.
132. Kang EW, Clinch K, Furneaux RH, et al. A novel and simple colorimetric method for screening Giardia intetinalis and anti-giardial activity in vitro. Parasitol. 1998;117(Pt 3):229-234.
133. Busatti HGNO, Gomes MA. A simple colourimetric method to determine anti-giardial activity of drugs. Parasitol Res. 2007;101(3):819-821.
134. Sehgal AK, Grewal MS, Chakravarti RN, et al. Experimental giardiasis in albino rats. Indian J Med Res. 1976;64(7):1015-1018.
135. Vinayak VK, Sharma GL, Naik SR. Experimental Giardia lamblia infection in Swiss mice-a preliminary report. Indian J Med Res. 1979;70:195-198.
136. Craft JC, Nelson JD. Diagnosis of giardiasis by counterimmunoeletrophoresis of feces. J Infect Dis. 1982;145(4):499-504.
137. Hill DR, Guerrant RL, Pearson RD, et al. Giardia lamblia infection of suckling mice. J Infect Dis. 1983;147(2):217-221.
138. Schleinitz P, Justus P, Stenzel P, et al. A successful introduction of culture adapted Giardia intestinalis in rabbit model: ultrastructural features. Gastroenterology. 1983;84:1301.
139. Hewlett EL, Andrews JS, Ruffier JR, et al. Experimental infection of mongrel dogs with Giardia lamblia cysts and cultures trophozoites. J Infect Dis. 1982;145(1):89-93.
140. Kirkpatrick CE, Grenn GA. Susceptibility of domestic cats to infections with Giardia lamblia cysts and trophozoites from human sources. J Clin Microbiol. 1985;21(5):678-680.
141. Barbosa E, Calzada F, Campos R. Antigiardial activity of methanolic extracts from Helianthemum glomeratumLag and Rubus coriifolius Focke in suckling mice CD-1. J Ethnopharmacol. 2006;108(3):395-397.
142. Barbosa E, Calzada F, Campos R. In vivo antigiardial activity of three flavonoids isolated of some medicinal plants used in Mexican traditional medicine for the treatment of diarrhea. J Ethnopharmacol. 2007;109(3):552-554.
143. Belosevic M, Faubert GM, Maclean JD, et al. Giardia lamblia infections in Mongolian Gerbils: an animal model. J Infect Dis. 1983; 147(2):222-226.
144. Araújo NS, Mundim MJS, Gomes MA, et al. Giardia duodenalis: Pathological alterations in gerbils, Meriones unguiculatus, infected with different dosages of trophozoites. Exp Parasitol. 2008;118(4):449-457.
145. Faubert GM, Belosevic M, Walker TS, et al. Comparative studies on the pattern of infection with Giardia spp. In Mongolian gerbils. J Parasitol. 1983;69(5):802-805.
146. Vivesvara GS, Smith PD, Healy GR, et al. An immunofluorescence test to detect serum anibodies to Giardia lamblia. Ann Intern Med. 1988;93(6):802-805.
147. Buret A, Galli DG, Olson ME. Growth, activities of enzymes in the small intestines and ultrastructure of microvillous border in gerbils infected with Giardia duodenalis. Parasitol Res. 1991;77(2):109-114.
148. Mohamed SR, Faubert GM. Dissacharidase deficiencies in Mongolian gerbils (Meriones unguiculatus) protected against Giardia lamblia. Parasitol Res. 1995;81(7):582-590.
149. Zaat JO, Mank TH, Assendelft WJ. WITHDRAWN: Drugs for treating giardiasis. Cochrane Database Syst Rev. 2007;2:CD000217.
150. Escobedo AA, Cimerman S. Giardiasis: a pharmacotherapy review. Expert Opin Pharmacother. 2007;8(12):1885-1902.
151. Upcroft P, Upcroft JA. Drug targets and mechanisms of resistance in the anaerobic protozoa. Clin Microbiol Rev. 2001;14(1):150-164.