For giardiasis in a patient with intolerance to metronidazole, several effective alternatives exist. Tinidazole is a nitroimidazole like metronidazole but is often better tolerated and can be given as a single dose (2g). However, cross-reactivity can occur. Nitazoxanide is a broad-spectrum antiprotozoal with a different mechanism and is well-tolerated, given as 500mg twice daily for 3 days. Paromomycin, a non-absorbable aminoglycoside, is another alternative, especially in pregnancy, but requires a longer course (10 days). Quinacrine is also effective but has more side effects. Among the options, Nitazoxanide is a widely accepted, well-tolerated, and effective first-line alternative. Albendazole (B) has activity but is not typically first-line for giardiasis monotherapy. Ciprofloxacin (C) is for bacteria, not Giardia. Ivermectin (D) is for helminths, not protozoa.

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Zambia

• loveness Phiri – 1084 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies