Comparison between efficacy of single dose of tinidazole with a 7 day standard dose course of metronidazole in giardiasis

Giardia intestinalis is the most common intestinal protozoan in the under developed countries. Treatment of infection has some difficulties by metronidazole because of long course of therapy and various side effects. The objective of this study was to determine efficacy and side effects of tinidazole compared with metronidazole in the treatment of giardiasis in children. A randomized controlled clinical trial, 106 subjects [69 males, 37 females] with Giardia intestinalis infection admitted to out patients or private clinics in Hamdan, West of Iran, was treated with tinidazole or metronidazole. The study period was May 2002 to January 2003. Tinidazole 50 mg/kg single dose and metronidazole 15 mg/kg three times a day for seven days were given orally to children. Parasitological cure was documented when there was 3 times negative stool examination for giardiasis at 1-2 weeks after therapy. Thirty-seven of 42 individuals [88.1%] treated with tinidazole and 43 of 64 children [67.2%] treated with metronidazole had parasitological cure. Cure rates between two groups were significant statistically [P<0.01]. No major side effect were observed except two cases in metronidazole group who had mild headache and abdominal pain for two days and some had metallic taste. Three cases in tinidazole group had nausea, dizziness and headache. Tinidazole was more effective than metronidazole, produced fewer and mild side effects and is recommended as drug of choice in single dose therapy for giardiasis. Because of single dose administration, short course of therapy and good compliance of patients, this preparation is preferred to metronidazole in the treatment of giardiasis

Investigation the effect of different concentrations of carbomer and co solvent propylene glycol on the releasing process of tinidazole from vaginal aqueous gel

The ability of local mucoadhesive vaginal aqueous gel to deliver the antibacterial, antiprotozoal tinidazole [TND] to vaginal endolayers is dependent on its releasing out of the drug from vehicle to the mucosal layer of the vagina and then exert its local effect. This depends upon the physicochemical properties of the drug, vehicle and the composition of the releasing medium used. The effect of different concentration of carbomer 941[0.5, 1 and 2% w/w] on the release of TND [2%w/w] from the aqueous gel base in absence and presence of various concentration of propylene glycol [PG] to the stimulant vaginal fluid [S.V.F] medium was investigated. The release of TND from low concentration of carbomer [0.5% w/w] aqueous gel base was higher and its followed fickian mechanism of the release while an anomalous mechanism holds the releasing of drug from a high concentration of carbomer [1 and 2% w/w] aqueous gel base, the release of TND from aqueous gel containing low concentration of PG was markedly higher than that of aqueous gel having a higher concentration of PG. The solubility of TND in different concentration of PG: water solution were also investigated. The releasing method were carried out using both S.V.F [pH4.2] and citrate buffer [pH4.2]. It was found that the using of S.V.F considered to be useful for the evaluation of topically prepared vaginal dosage form as a releasing medium. Furthermore the swelling index or [swelling percent] of I gm carbomer polymer in S.V.F was measured after 4 hours incubation of the dry polymer in the fluid. The initial rate of swelling and the swelling equilibrium of [0.5, 1 and 2% w/w] dry carbomer in the S.V.F were also investigated, 0.5% w/w cabomer aqueous gel has a high rate of swelling and swelling to equilibrium size rapidly, while 1 and 2% w/w carbomer aqueous gel having a low rate of swelling and swelling to equilibrium size slowly

Comparison of one week and two weeks of triple therapy for the eradication of Helicobacter pylori in a Sri Lankan population: a randomised, controlled study.

INTRODUCTION: Resistance of Helicobacter pylori to antibiotics may be particularly high in parts of the tropics. Infection may prove difficult to eradicate in such situations, and there is some evidence of benefit in increasing the duration of treatment (triple therapy) from 1 week to 2 or 3 weeks. AIM: To assess the efficacy and tolerability of 1 week versus 2 weeks of triple therapy for eradication of H. pylori in a Sri Lankan population. METHODS: Eighty two patients aged 18-70 years with gastritis or peptic ulcer and testing positive for H. pylori infection were randomly allocated to two treatment groups. Both groups received omeprazole 20 mg, clarithromycin 250 mg, and tinidazole 500 mg. Group A (n = 42) received the trial medication twice daily for 1 week and the Group B (n = 40) twice daily for 2 weeks. H. pylori eradication was defined as a negative 14C labelled urea breath test at 2 weeks after completion of the therapy. RESULTS: H. pylori infection was eradicated in 36 (85.7%) patients in Group A and 36 (90%) patients in Group B (p = 0.9). Twenty three (55%) patients in Group A and 17 (43%) in Group B reported adverse effects attributable to trial medication (p = 0.387); none were serious. Three (7.5%) patients in Group B discontinued treatment due to adverse events that developed on days 7, 9 and 10. CONCLUSION: Twice daily treatment with clarithromycin, tinidazole, and omeprazole for 1 week is well tolerated and provides as good a rate of H. pylori eradication as 2-week therapy in Sri Lankan patients.

Ciprofloxacin-tinidazole combination, fluconazole- azithromicin-secnidazole-kit and doxycycline- metronidazole combination therapy in syndromic management of pelvic inflammatory disease: a prospective randomized controlled trial.

BACKGROUND: Pelvic inflammatory disease is a common problem faced by the gynecologists in there out patient department. AIM: The aim of the study was to evaluate the efficacy of three treatment combinations in the syndromic management of pelvic inflammatory disease in the out patient setting. SETTING DESIGN: In the medical college hospital patients presenting in gynecology out patient department were enrolled. MATERIAL AND METHODS: One hundred and sixty five women with diagnosis of pelvic inflammatory disease were randomized into three equal groups getting ciprofloxacin (500 mg) and tinidazole (600 mg) combination twice daily for 7 days (Group 1), a kit containing fluconazole (150 mg), azithromycin (1 gm) and secnidazole (2 mg) as one time dose (Group 2) and Doxycycline 100mg twice daily and metronidazole 200 mg thrice daily for seven days (Group 3). Severity score was determined on first visit and after 1 week and 4 weeks when patients were called for follow up. Statistical Analysis: Chisqare test, Krusker wallis test and Mann Whitney test. RESULTS: There was significant reduction in severity score after 1 week of treatment, which was further reduced after 4 weeks in all the three groups. Cure rate was highest in-group 1 (96%) followed by group 2 (93.5) and group 3 (91.3%) but the difference was not statistically significant. Resolution of inflammatory mass was highest in group 1. The incidence of side effects was highest and compliance was lowest in the doxycycline -metronidazole group, but the difference was not statistically significant. CONCLUSION: All the three treatment combinations were found to be equally effective in the syndromic management of pelvic inflammatory disease.

Factors affecting Helicobacter pylori eradication using a seven-day triple therapy with a proton pump inhibitor, tinidazole and clarithromycin, in brazilian patients with peptic ulcer

Triple therapy is accepted as the treatment of choice for H. pylori eradication. In industrialized countries, a proton pump inhibitor plus clarithromycin and amoxicillin or nitroimidazole have shown the best results. Our aims were: 1. To study the eradication rate of the association of a proton pump inhibitor plus tinidazole and clarithromycin on H. pylori infection in our population. 2. To determine if previous treatments, gender, age, tobacco, alcohol use, and non-steroidal anti-inflammatory drugs (NSAIDs) change the response to therapy. METHODS: Two hundred patients with peptic ulcer (upper endoscopy) and H. pylori infection (histology and rapid urease test - RUT) were included. A proton pump inhibitor (lansoprazole 30 mg or omeprazole 20 mg), tinidazole 500 mg, and clarithromycin 250 mg were dispensed twice a day for a seven-day period. Eradication was assessed after 10 to 12 weeks of treatment through histology and RUT. RESULTS: The eradication rate of H. pylori per protocol was 65 percent (128/196 patients). This rate was 53 percent for previously treated patients, rising to 76 percent for not previously treated patients, with a statistical difference p<0.01. No significant difference was observed regarding sex, tobacco use, alcohol consumption, and NSAID use, but for elderly patients the difference was p = 0.05. Adherence to treatment was good, and side effects were mild. CONCLUSIONS: A proton pump inhibitor, tinidazole, and clarithromycin bid for seven days resulted in H. pylori eradication in 65 percent of the patients. Previous treatments were the main cause of treatment failure

Eradication of Helicobacter pylori with lansoprazole based triple therapy in peptic ulcer disease.

Lansoprazole 30 mg, amoxicillin 1000 mg, and tinidazole 500 mg were given twice daily to 39 peptic ulcer patients (26 duodenal and 13 gastric ulcer, mean age 52.4 +/- 15.01) who had H. pylori infection for two weeks. Additional lansoprazole 30 mg daily was given to duodenal and gastric ulcer patients for another two and six weeks respectively. Follow-up gastroduodenoscope was performed at fourth and eighth week and eighth and twelfth week for all duodenal and gastric ulcer patients, respectively. H. pylori status was evaluated by rapid urease test (CLO test) and histology at first and last endoscope. The ulcers were healed at the last endoscopy in 11 (85%) gastric ulcer patients and 24 (92%) duodenal ulcers patients. H. pylori infection was eradicated in 31 patients (79%). Mild side effects were observed in 15 per cent. In conclusion, 2 week regimen of lansoprazole, amoxicillin, and tinidazole triple therapy resulted in a relatively high healing rate of peptic ulcer (90%) and an acceptable eradication rate of H. pylori infection (79%).

Eficácia e tolerabilidade do secnidazol suspensão versus tinidazol suspensão no tratamento da giardíase em crianças / Efficacy and tolerability of secnizadol and tinizadol both in the suspension form in the treatment of giardiasis in children

Objetivo: Comparar a eficácia e tolerabilidade do secnidazol(SEC) e tinidazol(TIN) no tratamento da giardíase em crianças. Métodos: Em estudo multicêntrico, aberto, randomizado, 321 crianças de 2 a 14 anos de idade, dos sexos feminino e masculino e portadores de giardíase, receberam secnidazol suspensäo, 30mg/kg(N=160) ou tinidazol suspensäo, 50mg/kg(N=161), ambos em dose única. Todas as crianças apresentavam exame protoparasitológico positivo par Giardia lambia antes do tratamento e foram reavaliadas laboratorialmente (métodos Faust e Kato-Katz) 7, 14 e 21 dias após a administraçäo das drogas. Resultados: Cura parasitológica foi obtida em 95 porcento dos pacientes do grupo SEC e 97 porcento dos pacientes do grupo TIN, näo apresentando diferença estatística significativa (p=0,430). Eventos adversos, possível ou provavelmente relacionados ao medicamento em estudo, ocorreram em 7 porcento dos pacientes do grupo SEC versus 16 porcento do grupo TIN, uma diferença estatisticamente significativa (p=0,009). Os eventos individuais "gosto amargo" (1,9 porcento SEC vs 7,5 porcento TIN, p=0,018) e "vômito" (0,6 porcento SEC versus 4,3 porcento TIN, p=0,032) também tiveram uma incidência significativamente diferente nos dois grupos. Conclusöes: Secnidazol e tinidazol foram igualmente eficazes no tratamento da giardíase, mas o secnidazol apresentou melhor perfil de tolerabilidade nesta faixa etária

Tratamiento de la Amibiasis Intestinal Aguda: estudio comparativo Tinidazol/Teclozan Vs Secnidazol/Teclozán / Treatment of the acute intestinal ameobiasis: comparative study Teclozan/Tinidazol Vs Teclozan/Secnidazol

Se realizó un estudio controlado comparativo entre Tinidazol/Teclozan vs Secnidazol/Teclozan en el Estado Carabobo. El estudio fue efectuado en 160 pacientes del barrio El Carmen y de la Urbanización Alianza. Los resultados revelan que la combinación Secnidazol/Teclozan fue más efectiva que la combinación Tinidazol/Teclozan

Efficacy of triple therapy with PPI or H2 antagonist versus the elimination of helicobacter pylori

O Helicobacter pylori tem sido considerado importante fator nas doencas gastroduodenais e o esquema chamado triplice e o que mais se aceita no momento para a sua terapeutica. Neste estudo incluiram-se 14 pacientes portadores de gastrite cronica, 30 com ulcera gastrica e 16 com ulcera duodenal. Foram divididos em 2 grupos homogeneos para tratamento clinico, cada um com esquema bem definido: grupo A - claritromicina 250mg/2, tinidazol 250mg/2 e omeprazole 20mg em caso de gastrite e 40mg em caso de ulcera; grupo B - mesmos antibioticos e ranitidina respectivamente nas doses de 150 e 300mg. O periodo de tratamento foi de 7 dias para gastrites e 4 semanas para ulceras. Atraves de endoscopia e biopsia realizadas 30 dias depois do termino do tratamento, os 30 casos do grupo A tiveram erradicacao completa do Helicobacter pylori e cicatrizacao das ulceras. No grupo B, apenas 3 casos nao tiveram eliminacao do Helicobacter pylori. Concluiu-se que o uso de bloqueadores H2 no lugar de inibidores da bomba protonica tambem permite a obtencao de sucesso terapeutico

Evaluation of secnidazole gel and tinidazole suspension in the treatment of giardiasis in children

Giardiasis is a cosmopolitan parasitosis. Diarrhea, abdominal colic, and flatulence are the main clinical symptoms, however, malabsorption, and impairment of growth of children may occur. The 5-nitroimidazoles are drugs of choice in the treatment of giardiasis. Methods: The efficacy and tolerability of secnidazole and tinidazole were evaluated in a randomized, open-label clinical trial performed with 267 Giardia lamblia-positive children. Secnidazole , in a new gel formulation, and tinidazole suspension were prescribed as single oral doses of 30mg/kg and 50mg/kg, respectively. Clinical and parasitological follow-up was carried out before, and at 7, 14, and 21 days after treatment. Results: Clinical cure was observed in 77,3 percent and 75,7 percent of the patients in the secnidazole and tinidazole groups, respectively. Parasitological cure was obtained in the 91,3 percent and 89,6 percent in the secnidazole and tinidazole groups, respectively. A metallic taste after drug ingestion was more commonly reported in the tinidazole group than in the secnidazole group (p<0.05). Conclusions: The authors conclude that both secnidazole gel and tinidazole administered as a single oral dose are effective treatments for children with giardiasis since both high cure rates and good tolerability were observed

A combination of sulphadiazine, trimethoprim and metronidazole or tinidazole in kala-azar.

Nine patients of kala-azar showed good response to treatment with a combination of sulphadiazine, trimethoprim and metronidazole or tinidazole given orally for 12 to 25 weeks. No untoward side effect was noticed. Tinidazole sulphadiazine and trimethoprim combination was found to be safer for treatment of kala-azar in pregnant women.

Control de giardiasis en una zona suburbana de la provincia de la Habana / Control of giardiasis in province ciudad de la habana

Se asignaron aleatoriamente 250 personas (49 familias) y 230 personas (52 familias) a grupos I y II respectivamente, que son objeto de dos intervenciones diferentes. Los grupos tenían en común las condiciones de saneamiento básico, eran atendidos por el mismo grupo de atención primaria y una prevalencia de G. lamblia de 21 por ciento en cada uno de ellos. Al grupo I se les administró quimioterápia con tinidazol a 50 mg/Kg de peso sin pasar de 2 gramos en dosis repetidas por 3 días y a sus miembros se les orientó con medidas de higiene que se verificaron en el hogar en un período de 30 días por dos años. Al grupo II se les indicó recetas médicas con tinidazol a igual dosis y a sus miembros se les orientó con medidas higiénicas desde la porta médica pero no se efectuaron los controles de su aplicación en el hogar. En 1992 se observó un importante descenso en la prevalencia de GH. lamblia y no se observó reinfección e incidencia en el grupo I; en cambio en el grupo II estos indicadores no se redujeron significativamente. Se recomienda que la estrategia de dispensarización del equipo médico de atención primaria unido a la quimioterapia controlada sea el método adecuado para reducir esta parasitosis en la comunidad.

Ensayos terapéuticos en la estomatitis aftosa recurrente / Therapeutical assays in the recurrent aphthous stomatitis

Un total de 82 pacientes con estomatitis aftosa recurrente (EAR) en los que se detectó un parasitismo producido por Giardia lamblia fueron distribuídos en 3 grupos de tratamiento. Recibió trinidazol sólo el primer grupo, tinidazol más levamisol el segundo y tinidazol más tratamiento local en peridontone el tercero. Se siguieron durante 6 meses después del tratamiento para valorar la recurrencia de sus lesiones. Se apreció una mejoría en el 72% del total de casos sin diferencias significativas entre los 3 grupos, aunque el periodontone produjo una mejoría rápida sintomática. En el 63% de los casos que recidivaron antes del sexto mes, existió una reinfección en el parasitismo producido por Giardia lamblia, por lo que debe procederse al diagnóstico del mismo en todo paciente con EAR.

Seven day metronidazole versus single dose tinidazole as therapy for nonspecific vaginitis.

A comparative study of the treatment of nonspecific vaginitis was carried out in 171 reproductive-aged women. The patients were randomly treated with either metronidazole or tinidazole (Ninety-three patients in Group I, received oral metronidazole 1 g daily for 7 days. Another 78 patients in Group II, received oral tinidazole 2 g single dose. The patients were advised to return for follow-up examinations 1-2 weeks after treatment in their nonmenstrual period. Of these, 50 patients in each group were subject to complete study. The cure rates were 92 per cent in Group I and 86 per cent in Group II. The difference was not significant statistically. The adverse drug reactions among the two groups were 22 and 8 per cent respectively. Tinidazole is another effective drug for the treatment of nonspecific vaginitis.

Tratamiento de la vaginitis: Empleo de Tinidazol oral y Tioconazol unguento al 6.5 / Treatment of vaginitis: Use of oral Tinidazol and topic Thioonazole 6.5

Veintisiete pacientes en quienes por sus signos y sintomas se hizo el diagnostico de vaginitis, fueron tratadas con dosis unicas, simultaneas de 2 g orales de tinidazol y una aplicacion de unguento vaginal de tioconazol al 6.5%. El diagnostico clinico fue corroborado por el laboratorio en solo el 41% de los casos. El patogeno mas fecuentemente encontrado fue Candida albicans , en cuatro de estos asociado a Trichomonas vaginalis. Este ultimo se observo en un total de 13 casos (48%), hallandose como patogeno unico en seis casos. La Gardnerella vaginalis se evidencio en cuatro casos, en tres de los cuales asociada a Trichomonas vaginalis. En ningun caso se presento la asociacion de los tres organismos. El tratamiento empleado, por su eficacia, facil dosificacion y buena tolerancia, es una excelente alternativa cuando, por cualquier razon, no pueda hacerse el diagnostico etiologico previo. Para disminuir aun mas la posibiliad de fracasos terapeuticos, se recomienda insistir en el tratamiento al conyuge con tinidazol en todos los casos