Acceso usuarios
Evila Dávila de Campagnaro, Carla Olivo Cuesta, María Alejandra Méndez Camacho
La parasitosis intestinal es una enfermedad frecuente en el niño, con terapéutica diversa y efectividad controversial.
El objetivo de este estudio fue comparar la efectividad del metronidazol, secnidazol y albendazol en niños. Se incluyeron 399 pacientes, de 2 meses a 14 años en tres grupos. Grupo A (niños con amibiasis, subgrupos A1 con metronidazol y A2 con secnidazol), Grupo B (giardiasis, B1 con metronidazol, B2 con secnidazol y B3 con albendazol) y el C (blastocistosis, subgrupos C1 con etronidazol y C2 con secnidazol), atendidos en el Instituto Autónomo Hospital Universitario de los Andes, Ambulatorio Las González y Hospital La Azulita, ubicados en el estado Mérida, Venezuela, durante el año 2005. Las parasitosis con mayor incidencia fueron Entamoeba histolytica (49.1%), Blastocystis hominis (32.5%) y Giardia lamblia (18.2%). Los niños en edad escolar estuvieron representados en el 52.1% y los lactantes, preescolares en 64.3% que en su mayor parte procedían del medio sub- urbano y rural. La clínica dependió de la etiología parasitaria. Consideramos mejoría clínica si desaparecía la sintomatólogía y cura parasitológica si el coproanálisis de control era negativo. Niños con amibiasis presentaron similar mejoría clínica con ambos medicamentos y mayor cura parasitológica con secnidazol, los niños con giardiasis mayor mejoría clínica y parasitológica con secnidazol y baja efectividad con albendazol; en los niños con Blastocystis hominis , mayor mejoría clínica y parasitológica con metronidazol. Concluimos que el secnidazol tiene mayor efectividad terapéutica en la amibiasis y la giardiasis y el metronidazol en niños con Blastocystis hominis , no recomendamos el albendazol contra la giardiasis.
Intestinal parasitosis is a frequent disease in children with diverse therapies and controversial effectiveness. The aim of this study was to compare the effectiveness of metronidazole, secnidazole and albendazole as monotherapies in children. 399 children were included and divided in three groups. Group A were of children with amoebiasis divided in two subgroups: A1 treated with metronidazole and A2 with secnidazole. Group B presented giardiasis.
Subgroup B1 treated with metronidazole, B2 with secnidazole and B3 with albendazole. Group C presented blastocystosis and its subgroups C1 and C2 were treated with metronidazole and secnidazole respectively. Patients were children from two months to 14 years of age, attending the Autonomous University Hospital los Andes, Las González Out-Patient Clinic and the La Azulita Hospit al, in Mérida state, Venezuela during 2005. The most frequent parasitosis was Entamoeba histolytica (49.1%), Blastocystis hominis (32.5%) and Giardia lamblia (18, 2%). Pre-school and school children were 52.1% and 64.3% from the suburban and rural areas. The clinical exam depended on the parasite etiology. We considered clinical improvement if the symptoms disappeared, and the parasitology was cured if the copro-analysis was negative.
Children with amebiasis presented similar clinical improvement with both medicines and greater parasitological cure with secnidazole. Children with giardiasis showed greater clinical improvement and parasitology cure with secnidazole and low effectiveness with albendazole. Children with Blastocystis hominis showed greater clinical improvement and parasitology cure with metronidazole. We conclude that secnidazole has greater therapeutic effectiveness in children with amebiasis and giardiasis and metronidazole in children with Blastocystis hominis . We do not recommend albendazole against giardiasis.
