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Cryptosporidiosis - Treatment
Last reviewed: 04.07.2025
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Regime. Diet
A sufficiently complete diet (table No. 4) and adequate fluid intake (saline solutions for oral rehydration) are the main treatment for cryptosporidiosis in patients with mild or moderate course of the disease in the absence of disorders in the immune system. In severe cases, it is advisable to carry out intravenous rehydration in accordance with the degree of dehydration.
Etiotropic treatment of cryptosporidiosis
Etiotropic treatment of cryptosporidiosis has not been fully developed. There are no effective etiotropic treatments.
Due to the long, chronic and severe course of the disease in AIDS patients, it is necessary to carry out complex therapy from the first days of the disease:
- modern antiretroviral drugs (help relieve diarrhea, gradually improve immunity);
- oral or intravenous rehydration;
- enzyme preparations;
- symptomatic remedies.
Antibacterial drugs: azithromycin, paromomycin in maximum doses for 1.5 months. However, the effectiveness of antibiotics has not been confirmed by evidence-based medicine methods.
The most up-to-date treatment for cryptosporidiosis in HIV-infected individuals is recommended by Johns Hopkins University:
- paromomycin orally 500 mg four times a day for 2-4 weeks, then 1 g per day;
- a combination of paromomycin (2 g per day) and azithromycin (0.6 g four times per day) for 4 weeks, then paromomycin alone for 8 weeks;
- Nitazoxanide (1 g daily):
- octreotide (50-500 mg subcutaneously or intravenously three times a day);
- azithromycin (orally 1.2 g twice a day, then 1.2 g per day for 27 days, and then 0.6 g daily).
In all cases, treatment of cryptosporidiosis is long-term (at least 1-1.5 months), sometimes lifelong (depending on the severity of the AIDS patient's condition). In this case, antiretroviral treatment of cryptosporidiosis, combating dehydration, and high-calorie nutrition (parenteral if necessary) are necessary.
The prognosis for patients with HIV infection at the AIDS stage is unfavorable: cryptosporidiosis develops with a very low immune status, there is no effective etiotropic treatment for cryptosporidiosis, even with adequate pathogenetic and antiretroviral therapy, the number of CD4 lymphocytes does not have time to increase to a protective level. In patients with a normal number of CD4 lymphocytes or minor immunodeficiency, the prognosis is favorable.
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