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  • Title: Quinacrine Treatment of Nitroimidazole-Refractory Giardiasis.
    Author: Ydsten KA, Hellgren U, Asgeirsson H.
    Journal: J Infect Dis; 2022 May 16; 225(10):1773-1776. PubMed ID: 34036328.
    Abstract:
    BACKGROUND: Limited evidence exists on efficacy and tolerability of quinacrine for nitroimidazole-refractory giardiasis. METHODS: Nitroimidazole-refractory giardiasis cases, defined as microbiologically (microscopy and/or PCR) confirmed treatment failure after 2 courses, during 2008-2020, were retrospectively identified. RESULTS: Of 87 patients, 54 (62%) had visited India. Quinacrine was used in 54 (62%); 51 received monotherapy and 3 combined with metronidazole. Only 3 had positive stool samples with persisting symptoms after quinacrine treatment (94% parasitological efficacy) and all were cured after a second treatment. One (1.9%) had mild adverse effects recorded. CONCLUSIONS: Quinacrine is an effective treatment for nitroimidazole-refractory giardiasis with good tolerability.
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