Recommendations
| Dosage | Remarks | |
|---|---|---|
|
1st choice
|
metronidazole p.o. 500 mg three times daily for 5 days
|
|
|
albendazole p.o. 400 mg twice daily for 7 days
+ metronidazole p.o. 500 mg three times daily for 7 days |
SWAB remarks If inadequate response or recurrence |
Asymptomatic carriage occurs. In the Netherlands, it is preferable to treat asymptomatic carriage. In household situations this can prevent ongoing transmission. It also prevents microdamage to the intestinal epithelium.
Treatment with metronidazole is usually effective (± 90%). Therapy-resistant infections can occur. In these cases a combination of metronidazole and albendazole can be effective.
Tinidazole is the best agent, but difficult to obtain (not registered in the Netherlands, but can be obtained via an import licence). Tinidazole is available at Radboudumc. Dosage: single dose 2000 mg p.o.
In pregnancy, first-line is to defer treatment until after delivery if symptoms are mild. If treatment is indicated: paromomycin p.o. 500 mg three times daily for 7 days