Daycare workers with giardiasis present with bloating, flatulence, and foul-smelling stools. What is the treatment of choice?

Daycare workers with giardiasis present with bloating, flatulence, and foul-smelling stools. What is the treatment of choice?

• A. Metronidazole
• B. Amoxicillin
• C. Fluconazole
• D. Ciprofloxacin

Answer: (A)

Giardiasis is a protozoal infection of the intestine that often presents with bloating, gas, and foul-smelling stools, common in daycare settings. Metronidazole is the recommended treatment because it is highly effective against Giardia lamblia and has good oral absorption and tissue penetration, leading to rapid symptom improvement. Its mechanism involves disruption of DNA synthesis in anaerobic organisms after reduction of the nitro group, making Giardia susceptible to the drug. Patients should avoid alcohol during treatment due to a potential disulfiram-like reaction. The other options are not active against Giardia: amoxicillin targets bacteria, fluconazole targets fungi, and ciprofloxacin targets bacteria.

Giardiasis is a protozoal infection of the intestine that often presents with bloating, gas, and foul-smelling stools, common in daycare settings. Metronidazole is the recommended treatment because it is highly effective against Giardia lamblia and has good oral absorption and tissue penetration, leading to rapid symptom improvement. Its mechanism involves disruption of DNA synthesis in anaerobic organisms after reduction of the nitro group, making Giardia susceptible to the drug. Patients should avoid alcohol during treatment due to a potential disulfiram-like reaction. The other options are not active against Giardia: amoxicillin targets bacteria, fluconazole targets fungi, and ciprofloxacin targets bacteria.