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All Journal International Journal of Public Health Science (IJPHS) Jurnal Sain Veteriner Jurnal Kesehatan Lingkungan indonesia e-Journal Pustaka Kesehatan Althea Medical Journal Majalah Geografi Indonesia Jurnal Kesehatan Jurnal Kesehatan Andalas Folia Medica Indonesiana Damianus Journal of Medicine Journal of Agromedicine and Medical Sciences Jurnal Media Gizi Indonesia (MGI) JURNAL KESEHATAN LINGKUNGAN (Journal of Environmental Health) The Indonesian Journal of Occupational Safety and Health UNEJ e-Proceeding Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) Jurnal Manajemen Kesehatan Yayasan RS.Dr. Soetomo Al-sihah: The Public Health Science Journal Jurnal Medik Veteriner Hearty : Jurnal Kesehatan Masyarakat J-Dinamika: Jurnal Pengabdian Kepada Masyarakat Journal of Health Sciences ARTERI : Jurnal Ilmu Kesehatan MAHESA : Malahayati Health Student Journal Solo Journal of Anesthesi, Pain and Critical Care JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Berita Kedokteran Masyarakat Jember Medical Journal (JMJ) Indonesian Journal of Biomedicine and Clinical Sciences Journal of Agropharmacy
Wiwien Sugih Utami
Department Of Parasitology, Faculty Of Medicine, Universitas Of Jember, Jember 68121, Indonesia
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Dentistry Earth & Planetary Sciences Education Electrical & Electronics Engineering Environmental Science Health Professions Immunology & microbiology Library & Information Science Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary Other

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Journal : Folia Medica Indonesiana

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Combination Therapy for Cryptosporidiosis in Immunocompromised Patients Wiwien Sugih Utami; M.S. Irham Rozaq; Laksmi Indreswari; Cholis Abrori; Bagus Hermansyah
Folia Medica Indonesiana Vol. 60 No. 4 (2024): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v60i4.60340

Abstract

Cryptosporidium sp. is a gastroenteritis-causing pathogen that may increase mortality and morbidity in immunocompromised patients. Diarrhea is a common problem among acquired immunodeficiency syndrome (AIDS) patients, with 30–60% of patients in developed countries and 90% in developing countries affected. The prevalence of cryptosporidiosis is 3–5% of the global population, with 14.42% of those affected being immunocompromised. There is currently no vaccine available to prevent cryptosporidiosis, while nitazoxanide monotherapy is ineffective in eradicating the organism in immunocompromised hosts and malnourished children. This study aimed to determine the most effective combination therapy for cryptosporidiosis in immunocompromised patients. This study used a systematic review design and implemented eligibility criteria for the literature search across PubMed, ScienceDirect, Epistemonikos, Google Scholar, Nature, Springer, and John Wiley databases. The search utilized specific keywords and Boolean operators, i.e., “Cryptosporidium,” OR “cryptosporidiosis,” AND “combination therapy,” OR “combination treatment,” AND “immunocompromised.” Two cohort studies and two case reports were selected, three of which used a nitazoxanide and azithromycin combination as the intervention, whereas only one cohort study used a nitazoxanide and fluoroquinolone combination. The studies comprised 54 samples from post-kidney transplantation patients and one sample from an acute lymphoblastic leukemia (ALL) patient. The nitazoxanide and fluoroquinolone combination showed superior outcomes than the nitazoxanide and azithromycin combination. The stool clearance was significantly lower with nitazoxanide monotherapy than the nitazoxanide and fluoroquinolone combination (OR=0.65, 95% CI=0.34–0.92, p=0.01). However, it was non-significantly lower with the nitazoxanide and azithromycin combination compared to monotherapy (OR=0.27, 95% CI=0.01–5.77, p=0.24). Nitazoxanide monotherapy exerted a significantly lower effect than the nitazoxanide and fluoroquinolone combination in stopping diarrhea symptoms (OR=0.45, 95% CI=0.21–0.81, p=0.004). In conclusion, a combination therapy using nitazoxanide and fluoroquinolone for cryptosporidiosis in immunocompromised patients offers more favorable outcomes compared to monotherapy, particularly in stopping diarrhea and enhancing stool clearance.
Co-Authors Achmad Ilham Tohari Achmad Maududie Achmad Nazalal Furqon Adella Bintang Saputri Adinda Putri Yusri Amrina Amrina, Adinda Putri Yusri Angga Mardro Raharjo Anita Dewi Prahastuti Sujoso, Anita Dewi Prahastuti Ardyansyah, Rizky Robeth Arina, Yuliana Mahdiyah Daat Aris Prasetyo Asis Fitriana Aulya Rahmi Ayundasari, Asti Ayundasari, Asti Azham Purwandhono Aziz, Ayu Munawaroh Bagus Hermansyah Bagus Hermansyah Bagus Hermansyah Bagus Hermansyah Baskoro Adi Prayitno Brillian Adexa Yudinda Cholis Abrori, Cholis Devita Prima Nurmasari Dewi Rokhmah Dian Eka Putri Harnandhari Diana Chusna Mufida Dicky Setiawan Dini Agustina Dita Diana Parti Drajad, Rahadinda Mutia Dhamar Dwi Prijatmoko Dwita Aryadina Rachmawati Elvia Rahmi Marga Putri ENNY SUSWATI Eny Nurmaida Epafroditus Sanjaya Adiguna Erfan Efendi Erma Sulistyaningsih Erma Sulistyaningsih Faizatun Nikmah, Faizatun Febrianti, Zahrah Ghaiska Najma Amnur Hanu Neda Septian Heni Fatmawati Hermansyah, Bagus Ida Srisurani Wiji Astuti Ika Barokah Suryaningsih Ika Rahmawati Sutejo Ika Rahmawati Sutejo Ika Sriwinarti Ilamto, Bambang Irawan Fajar Kusuma Isa Ma'rufi Isa Ma’rufi Jauhani, M. Afiful Jauhar Firdaus Kesy Sasta Handani Khoiruddin, Mukhammad Arif Hadi Kristianningrum Dian Sofiana Laily Nurhayati Laksmi Indreswari Laksmi Indreswari Laksmi Indreswari Leersia Yusi Ratnawati M. Ali Shodikin M.S. Irham Rozaq Mash’ab Zirrun Al-Qomah Mauliya Sri Sukmawati Wahyudi Muhammad Afiful Jauhani Muhammad Afiful Jauhani Muhammad Afiful Jauhani Muhammad Zainul Fikri Mukhammad Arif Hadi Khoirudin Nabila Putri Anissa Nanda Nuramna Nanik Kurniati Nanik Kurniyati Nidia Nursafitri Nindya Shinta Rumastika Nur Hasyimiyyah Nuri Nurmaida, Eny Nurmaida, Eny Nurus Saffana Yulianto Pangestu, Ahmad Yudho Hadi Pradana, Tasya Lukita Cyndi Pralampita, Pulong Wijang Prriantono, Dwinda Pungky Setya Arini Putra, Muhamad Dwi Eka Rachmawati, Dwita Aryadina Rahardi, Verdian Rahardjo, Angga Mardro Rahmi, Aulya Ramadanti, Novi Awalia Ramadhani, Rafindra Ratnawati, Leersia Yusi Rena Normasari Rifaldy Nabiel Erisadana Sa'bani, Begawan Salsabilla, Safira Putri Nur Selly Silfana Liensa Sugeng Winarso Sulistyaningsih, Erma Syamsuddin, Alif Fazduani Tartila, Jasmine tunsiah, tunsiah Widjaja Putra, Bayu Taruna Yehuda Tri Nugroho Supranoto Yoga Setyo Yudha Nurdian Yudi Wicaksono Yunita Armianti Yunita Armiyanti Zulaikha Rizqina Rahmawati