Cryptosporidiosis: Treatment
Last reviewed: 23.04.2024
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Mode. Diet
A sufficiently high-grade diet (table number 4) and the intake of an adequate amount of liquid (saline solutions for oral rehydration) is the main treatment for cryptosporidiosis in patients with mild or moderate course of the disease in the absence of disturbances 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 is not fully developed. There are no effective means of etiotropic therapy.
Due to the long, chronic and severe course in AIDS patients, it is necessary to carry out complex therapy from the first days of illness:
- modern antiretroviral drugs (contribute to the arrest of diarrhea, gradually improve immunity);
- oral or intravenous rehydration;
- enzyme preparations;
- symptomatic means.
Antibacterial drugs: azithromycin, paromomycin in maximum doses for 1.5 months. However, the effectiveness of antibiotics using evidence-based medicine has not been confirmed.
The most modern treatment for cryptosporidiosis in carriers of HIV infection is recommended by the Johns Hopkins University:
- paromomycin inside 500 mg four times a day for 2-4 weeks, then 1 g per day;
- combination of paromomycin (2 g per day) and azithromycin (0.6 g four times a day) for 4 weeks, then only paromomycin 8 weeks;
- nitazoxadine (1 g per day):
- octreotide (50-500 mg subcutaneously or intravenously three times a day);
- azithromycin (inside 1.2 g twice per day, then 1.2 g per day for 27 days, and then 0.6 g daily).
In all cases, the treatment of cryptosporidiosis is long (at least 1-1.5 months), sometimes lifelong (depending on the severity of the condition of the patient with AIDS). In this case, antiretroviral treatment of cryptosporidiosis, fighting with dehydration, caloric nutrition (if necessary parenteral) is necessary.
The prognosis in patients with HIV infection in the stage of AIDS is unfavorable: the disease of cryptosporidiosis develops at a very low immune status, effective etiotropic treatment of cryptosporidiosis is absent, even with adequate pathogenetic and antiretroviral therapy, the number of CD4 lymphocytes does not have time to rise to a protective level. In patients with a normal number of CD4-lymphocytes or insignificant immunodeficiency, the prognosis is favorable.
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