Journal Article

<i>In vitro</i> effects of nitazoxanide on <i>Echinococcus granulosus</i> protoscoleces and metacestodes

Mirjam Walker, Jean François Rossignol, Paul Torgerson and Andrew Hemphill

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 54, issue 3, pages 609-616
Published in print September 2004 | ISSN: 0305-7453
Published online September 2004 | e-ISSN: 1460-2091 | DOI:
In vitro effects of nitazoxanide on Echinococcus granulosus protoscoleces and metacestodes

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  • Medical Oncology
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Objectives: Infection of humans and domestic ruminants with the larval stage (metacestode) of Echinococcus granulosus results in cystic echinococcosis (CE). The metacestode causes a space-occupying lesion in visceral organs, most commonly in the liver. Benzimidazole carbamate derivatives, such as mebendazole and albendazole, are currently used for chemotherapeutic treatment of CE. In human patients, benzimidazoles have to be applied in high doses for extended periods of time, and adverse side effects are frequently observed. In order to evaluate alternative treatment options, the in vitro efficacy of nitazoxanide, a broad-spectrum drug used against intestinal parasites and bacteria, was investigated.

Methods: Freshly isolated E. granulosus protoscoleces were subjected to nitazoxanide treatment (1, 5 and 10 μg/mL), and the effects on parasite viability were monitored by Trypan Blue staining and scanning electron microscopy. Protoscolex cultures were maintained further, until metacestode development took place. Metacestodes were then subjected to nitazoxanide treatment (10 μg/mL), and corresponding effects were visualized by scanning and transmission electron microscopy.

Results: Dose-dependent protoscolex death within a few days of nitazoxanide treatment was observed. Subsequent in vitro culture of drug-treated protoscoleces confirmed the non-viability of parasites, while further cultivation of non-treated protoscoleces for a period of at least 3 months resulted in stage conversion and the formation of small metacestodes 3–4 mm in diameter. Nitazoxanide had a deleterious effect on these metacestodes, which was comparable to that of albendazole.

Conclusions: Our study indicates a potential for nitazoxanide as an alternative treatment option against CE.

Keywords: E. granulosus; cystic echinococcosis; in vitro drug treatment; albendazole

Journal Article.  3968 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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