In vitro analysis shows that combinations of metronidazole and other drugs effectively treat giardiasis, suggesting potential therapeutic options.
Background Drug-combination therapies are needed to combat treatment refractory giardiasis. However, data describing the activity of combinations of currently used drugs against Giardia duodenalis are unavailable. Methods The in vitro activity of combinations of currently used antigiardial drugs were investigated against G. duodenalis. Results Combinations of metronidazole with albendazole or quinacrine, and quinacrine with nitazoxanide, behaved additively, whereas combinations of metronidazole with nitazoxanide, albendazole or quinacrine behaved synergistically. Combinations of albendazole with nitazoxanide behaved antagonistically. Conclusions While combinations of metronidazole with nitazoxanide, or albendazole with quinacrine, may be effective treatments of giardiasis, combinations of albendazole with nitazoxanide are likely to result in negative pharmacodynamic interactions.
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Fayd’Herbe et al. (2025) studied this question.
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