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.
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. Tetracycline 500 mg PO is given four times a day for 10 days. Iodoquinol, puromycin, and nitazoxanide are also effective against balantidiasis.
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.
Metronidazole (Flagyl)
Synthetic drug with antiprotozoal and antibacterial action used to treat symptomatic patients with diarrhea.
Iodoquinol (Yodoxin)
Contact amebicide works in the lumen of intestine.
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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).
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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).
