From the Research
Treatment for Blastocystis hominis infection is generally only recommended when patients are symptomatic and other causes of gastrointestinal symptoms have been ruled out, with the first-line treatment being metronidazole at a dose of 500-750 mg three times daily for 7-10 days, as supported by the most recent study 1. The choice of treatment is based on the patient's symptoms and the presence of other pathogens.
- Metronidazole is considered the first-line treatment, but its efficacy has been questioned in recent studies 1.
- Alternative medications include trimethoprim-sulfamethoxazole (TMP-SMX) at a dose of 160/800 mg twice daily for 7-10 days, or nitazoxanide 500 mg twice daily for 3 days.
- For patients who fail initial therapy, combination treatments may be considered, such as metronidazole plus paromomycin, or secnidazole 400 mg three times daily for 3 days. The rationale for treatment is that B. hominis may cause gastrointestinal symptoms through direct invasion of intestinal epithelium, inflammatory response induction, or alteration of the gut microbiome, though its pathogenicity remains somewhat controversial, as discussed in 2 and 1. It's essential to note that treatment may not always eradicate the organism, and some patients experience symptom improvement without complete clearance, highlighting the need for further research on the efficacy of different treatments, as suggested by 3 and 4. Good hygiene practices, including handwashing and avoiding potentially contaminated food and water, should accompany treatment to prevent reinfection. The most recent study 1 provides the most up-to-date information on the antimicrobial susceptibility patterns of Blastocystis, which is crucial for guiding treatment decisions.