Use of nitazoxanide for gastrointestinal tract infections: treatment of protozoan parasitic infection and beyond.

The United States Food and Drug Administration has approved the parasiticidal agent nitazoxanide for treatment of diarrhea caused by Giardia lamblia/intestinalis or Cryptosporidium parvum. This novel agent has a broad spectrum of activity against many other gastrointestinal pathogens, including bacteria, roundworms, flatworms, and flukes. Nitazoxanide is used in many areas of the world, especially in Central and South America, as a broad-spectrum parasiticidal agent in adults and children. Nitazoxanide appears to be well tolerated, has a relatively low incidence of adverse effect, and displays no significant known drug-to-drug interactions. Recently, preliminary reports indicate that nitazoxanide may be an effective treatment for Clostridium difficile-associated diarrhea as well. Future work will likely solidify and further expand the role of nitazoxanide in the treatment of a wide range of intestinal pathogens.