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Open AccessArticle

Predictors of Failure from Primary Therapy for Giardiasis in San Diego: A Single Institution Retrospective Review

1
Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA
2
Department of Pathology, University of California San Diego, La Jolla, CA 92093, USA
3
Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
4
Departments of Medicine and Family Medicine and Public Health, University of California San Diego School of Medicine, San Diego, CA 92103, USA
*
Author to whom correspondence should be addressed.
Pathogens 2019, 8(4), 165; https://doi.org/10.3390/pathogens8040165
Received: 9 September 2019 / Revised: 24 September 2019 / Accepted: 26 September 2019 / Published: 27 September 2019
(This article belongs to the Special Issue Emerging Parasitic Protozoa)
This study aimed to determine the presence of giardiasis among HIV patients in San Diego, the rate of failure of metronidazole treatment, and factors associated with treatment failure. We used a 7 year retrospective single-center case series of HIV-infected individuals with giardiasis at University of California San Diego Medical Center. Data were analyzed for the changes in the hematological, biochemical, and immunologic results at pre- and at-diagnosis levels. We also compared the changes at the diagnosis level among patients who were treated successfully and those who experienced treatment failure as defined by retreatment with a second course of antibiotics. In 29 Giardia lamblia-infected HIV patients, following diagnosis of G. lamblia, there was a non-significant decrement in cluster of differentiation 4 (CD4), but a statistically significant increase in the number of white blood cell (WBC). Other indices did not differ between pre- and at-diagnosis levels. Twenty patients (69%) were treated with a single course of metronidazole or tinidazole and seven patients (24.1%) were treated with more than one course of metronidazole. These seven patients had statistically significant higher hemoglobin at the time of diagnosis, but further studies are required to confirm if this is a consistent finding and if this can predict failure from primary therapy. View Full-Text
Keywords: metronidazole; giardia; HIV; treatment failure; retrospective metronidazole; giardia; HIV; treatment failure; retrospective
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Debnath, A.; Reed, S.L.; Morris, S.R. Predictors of Failure from Primary Therapy for Giardiasis in San Diego: A Single Institution Retrospective Review. Pathogens 2019, 8, 165.

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