Giardia lamblia
Treatment is indicated for symptomatic patients as well as asymptomatic carriers who present a risk of spread (food handlers, child in daycare, household contacts of pregnant women and immunocompromised individuals). Asymptomatic children should also be treated because of the potential impact on their growth.
1st line - Metronidazole 500 mg twice daily for 7 days (children: 15 mg/kg/day divided in 3 doses for 7 days, max 250 mg per dose) 2nd line - Mebendazole 200 mg orally three times per day for 5 days (for patients ≥ 2 years of age)
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* The drugs of choice for giardiasis are tinidazole and nitazoxanide, but these medications are not readily available in Canada. They have to be ordered through the Federal Special Access Programme and should thus be ordered by an Infectious Diseases specialist if the 2 regimens above fail to eradicate a symptomatic infection (giardia can be quite resistant to treatment).