Balantidiasis Medication

  • Author: Valda M Chijide, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Nov 22, 2011
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications. Prolonged courses of therapy may be required to cure balantidiasis in patients who are infected with HIV or who are otherwise immunosuppressed.

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Antibiotics

Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting. Tetracycline is the treatment of choice, with metronidazole being the primary alternative. Iodoquinol, puromycin, and nitazoxanide are also effective against balantidiasis.

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Tetracycline (Sumycin)

 

Isolated from a strain of Streptomyces aureofaciens. Exerts a bacteriostatic effect by reversibly binding to 30S and 50S ribosomal subunits of susceptible organisms, thereby inhibiting protein synthesis.

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Metronidazole (Flagyl)

 

Synthetic drug with antiprotozoal and antibacterial action used to treat symptomatic patients with diarrhea.

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Iodoquinol (Yodoxin)

 

Contact amebicide works in the lumen of intestine.

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Contributor Information and Disclosures
Author

Valda M Chijide, MD  Clinical Professor, Department of Medicine, University of Saskatchewan; Consultant in Infectious Diseases, Regina, Saskatchewan, Canada

Valda M Chijide, MD is a member of the following medical societies: American College of Physicians, HIV Medicine Association of America, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Jeffrey D Band, MD  Professor of Medicine, Oakland University William Beaumont School of Medicine; Director, Division of Infectious Diseases and International Medicine, Corporate Epidemiologist, William Beaumont Hospital; Clinical Professor of Medicine, Wayne State University School of Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Ronald A Greenfield, MD  Professor, Department of Internal Medicine, University of Oklahoma College of Medicine

Ronald A Greenfield, MD is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Central Society for Clinical Research, Infectious Diseases Society of America, Medical Mycology Society of the Americas, Phi Beta Kappa, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology

Disclosure: Pfizer Honoraria Speaking and teaching; Gilead Honoraria Speaking and teaching; Ortho McNeil Honoraria Speaking and teaching; Abbott Honoraria Speaking and teaching; Astellas Honoraria Speaking and teaching; Cubist Honoraria Speaking and teaching; Forest Pharmaceuticals Speaking and teaching

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

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  2. Ferry T, Bouhour D, De Monbrison F, et al. Severe peritonitis due to Balantidium coli acquired in France. Eur J Clin Microbiol Infect Dis. May 2004;23(5):393-5. [Medline].

  3. Vasilakopoulou A, Dimarongona K, Samakovli A, et al. Balantidium coli pneumonia in an immunocompromised patient. Scand J Infect Dis. 2003;35(2):144-6. [Medline].

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  10. Fisk T, Keystone J, Kozarsky P. Cyclospora cayetanensis, Isospora belli, Sarcocystis Species, Balantidium coli, and Blastocystis hominis. In: Mandell GL, Bennet JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 2. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2005:3228-37.

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  13. Micromedex. Tetracycline. Drugdex Drug Evaluations. micromedex. Available at http://www.micromedex.com. Accessed 2000.

  14. Neafie R. Balantidiasis. In: Pathology of Tropical and Extraordinary Diseases. Vol 1. Washington, DC: Armed Forces Institute of Pathology; 1976:325-7.

  15. PDR. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc; 2000.

  16. Rosenblatt JE. Antiparasitic agents. Mayo Clin Proc. Nov 1999;74(11):1161-75. [Medline].

  17. The Medical letter on drugs and therapeutics. Drugs for parasitic infections. Med Lett Drugs Ther. Jan 2 1998;40(1017):1-12. [Medline].

  18. Yazar S, Altuntas F, Sahin I, et al. Dysentery caused by Balantidium coli in a patient with non-Hodgkin's lymphoma from Turkey. World J Gastroenterol. Feb 1 2004;10(3):458-9. [Medline].

  19. Young MD. Attempts to transmit human Balantidium coli. Am J Trop Med Hyg. Jan 1950;30(1):71. [Medline].

 
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Trophozoite of Balantidium coli in colon. This photograph shows the large macronucleus and the thin cell membrane covered with cilia (X820). Courtesy of Armed Forces Institute of Pathology (AFIP 75-9300).
Cyst of Balantidium coli in feces. This photograph demonstrates a thick cyst wall and a large macronucleus (X820). Courtesy Armed Forces Institute of Pathology (AFIP 75-9301).
 
 
 
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