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JAC Advance Access originally published online on December 16, 2005
Journal of Antimicrobial Chemotherapy 2006 57(2):353-355; doi:10.1093/jac/dki456
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Efficacy of nitazoxanide and paromomycin in biliary tract cryptosporidiosis in an immunosuppressed gerbil model

A. Baishanbo1,2, G. Gargala1,3, C. Duclos4, A. François4, J.-F. Rossignol5, J. J. Ballet3 and L. Favennec1,*

1 Laboratoire de Parasitologie, ADEN EA3234, CHU Charles Nicolle, 76031 Rouen, France; 2 College of Pharmacy, Xinjiang Medical University, Urumqi, China; 3 Laboratoire d'Immunologie, EA 2128, CHU Clemenceau, 14033 Caen, France; 4 Service d'Anatomie Pathologique, CHU Charles Nicolle, 76031 Rouen, France; 5 Romark Institute for Medical Research, Tampa, FL 33607, USA

Received 21 March 2005; revised 30 September 2005; accepted 16 November 2005

* Corresponding author. Tel: +33-2-32-88-66-39; Fax: +33-2-32-88-68-75; E-mail: loic.favennec{at}chu-rouen.fr

Objectives: To evaluate the efficacy of nitazoxanide and paromomycin in biliary tract cryptosporidiosis in an immunosuppressed Mongolian gerbil (Meriones unguiculatus) model.

Methods: Gerbils (1-month-old) were dexamethasone-immunosuppressed for 10 days and challenged orally with 105 Cryptosporidium parvum oocysts. From day 0 to day 12 post-infection, one group (n = 14) was treated with 200 mg/kg/day nitazoxanide and another (n = 15) with 100 mg/kg/day paromomycin. Infection and efficacy of nitazoxanide and paromomycin were assessed by measuring oocyst shedding in faeces, biliary tract and ileum histological examination.

Results: In nitazoxanide-treated and paromomycin-treated groups as compared with untreated animals (P < 0.05), oocyst shedding was partially suppressed in a similar manner (P > 0.05). Parasites were present in histological sections of the ileal mucosa of 16/16 infected untreated animals versus 3/14 and 6/15 in the nitazoxanide-treated and the paromomycin-treated groups, respectively (P < 0.05). In addition, gall bladder infection was less frequent in nitazoxanide-treated (2/14, P < 0.01) and paromomycin-treated (5/15, P = 0.07) animals than in untreated controls (9/16). No histological alteration of biliary mucosa was observed in both treated and untreated infected gerbils.

Conclusions: Present data support the efficacy of nitazoxanide and, to a lesser extent, paromomycin on biliary C. parvum infection in gerbils, and prompt further investigation of the potential clinical benefits of nitazoxanide in treating human biliary cryptosporidiosis.

Keywords: Cryptosporidium parvum , Meriones unguiculatus , gall bladders , cryptosporidial cholangitis


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