Treatment and Control

Blastocystis hominis
Clinical Aspects
Treatment and Control

Table of Contents

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The requirement for treatment of B. hominis infections remains controversial. In the absence of conclusive evidence of pathogenicity of the organism, treatment with potentially dangerous drugs and the failure to investigate the true cause of symptoms in patients are of concern to many physicians.

However, other physicians believe that treatment of B. hominis infections is warranted when debilitating symptoms are present and no other cause of disease is obvious.



There are very few experimental data to verify the efficacy of the chemotherapy of B. hominis. The choice and dosage of drugs used for the treatment of B. hominis infections remain empirical.

Antiprotozoal drugs, particularly metronidazole or iodoquinol, commonly are recommended for treatment of B. hominis infections. Metronidazole is still the drug of choice now.

Recommended doses for metronidazole treatment of B. hominis infections include 250 to 750 mg three times per day for 5 to 10 days, 200 mg four times per day for up to 7 days, or 2 g/day for 5 days.

Chemotherapy does not appear to be required in asymptomatic individuals and may not be warranted in patients with mild or transient symptoms. Until the pathogenicity of B. hominis is properly defined, the existence of carrier states is determined, and the spontaneous elimination of parasites is assessed, the chemotherapy of infections with this organism will remain controversial.

Treatment should be used, with caution, only after a thorough clinical review of other possible causes of symptoms.

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Other Management Strategies

Considering the present data, it is reasonable to assume the fecal-oral route as the most likely for transmission of B. hominis. Thus, control measures would include good personal hygiene, improvement in community sanitary facilities, and education to prevent fecal contamination of the environment and ingestion of contaminated material.

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Summarized by Thirayost Nimmanon


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