Randomized trial of secnidazol versus metronidazol in the treatment of intestinal amoebiasis in children

ABSTRACT

Intestinal amoebiasis of children is an endemic disease in Iraq, and it is one of the leading causes of acute and chronic diarrhea. Noticeable resistance to the usually used antiprotozoal medication, especially in the last years had been repeatedly documented. To determine the effectiveness and safety of [Secnidazol] in the treatment of intestinal amoebiasis in pediatric age group. A study was performed on 200 children aged 10 months -7 years diagnosed as intestinal amoebiasis on the base of clinical ground and microscopical study. The children were allocated at random into one or another equal treatment groups of [100 children for each group]. Therapeutic dose of Metronidazol [40mg/kg/day for 7 days] started for the first group while for the second group, Secnidazol suspension [single dose of 30 mg/Kg/dose] was given. Both groups were followed for one week by clinical assessment and parasitological examination of the stool for the presence of Ent. histolytica [trophozoite and/or cysts]. The study showed that Metronidazol suspension had 18% clinical and 11% parasitological cure at day 1 compared to 83% clinical and 32% parasitological cure when using Secnidazol. These reached 72% clinical and 59% parasitological cure rate after 7 days of using Metronidazol compared to 91% clinical and 89% parasitological cure by effect of Secnidazol suspension. Secnidazol was more effective than Metronidazol for clinical and parasitological treatment of intestinal amoebiasis in children. In addition, Secnidazol is more palatable, and with a shorter duration of treatment [monotherapy] increasing the treatment compliance. Our results recommend to replace Metronidazol with Secnidazol suspension at least in resistant or intransigent cases of intestinal amebiasis