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METRONIDAZOL U TERAPIJI BLASTOCISTOZE KOD DECE
METRONIDAZOLE IN THE THERAPY OF BLASTOCYSTOSIS IN CHILDREN

Authors

 

Mirjana Stojšić1,2, Jovanka Kolarović1,2

1Institut za zdravstvenu zaštitu dece i omladine Vojvodine, Novi Sad, Srbija
2Medicinski fakultet Univerziteta u Novom Sadu, Srbija

 


Rad je primljen 21.08.2017. / Prihvaćen 25.08.2017

 


Correspondence to


Mirjana Stojšić, MD, PhD,
pediatrician-gastroenterohepatologist
Chief of Cabinet for GI endoscopy
Department of gastroenterology, hepatology and nutrition
Institute of Child and Youth Health Care of Voyvodina
Hajduk Veljkova 10,
21000 Novi Sad, Serbia
mobil : +381 62 20 33 40
e-mail: drstojsic@gmail.com

 

 

Sažetak

 

Blastocistis hominis (Bh) je najrasprostranjeniji protist na našoj planeti, ali pri tome najkontraverzniji. Infekcija Bh počinje ingestijom hrane ili tečnosti koja je kontaminirana cističnom formom Bh. Nakon gutanja, iz ciste se razvijaju u debelom crevu čoveka vakuolarne forme protista.  Fekalno - oralni prenos je najčešći put širenja infekcije. Oboljenje koje Bh izaziva kod ljudi naziva se blastocistoza. Najčešće kliničke manifestacije blastocistoze su gastrointestinalne, ali mogu biti prisutni i drugi nespecifični znaci. Terapija blastocistoze je neophodna kod  imunokompromitovane dece, bez obzira da li je ona simptomatska i asimptomatska, ali i kod imunokompetentnih osoba koje imaju tegobe. Najčešće preporučeni antibiotik za lečenje blastocistoze je metronizaol u trajanju 10 dana, primenjen peroralno. U slučaju  razvoja gastroenteroloških smetnji savetuje se promena načina aplikacije metronidazola i parenteralni put davanja.  Rezistencija na antibiotike je uslovljena genetskim karakteristikama Bh, jer različiti subtipovi Bh imaju različitu osetljivost na lekove, ali i geografskim položajem, jer rezistencija na određene antibiotike različita u različitim delovima sveta, u skladu sa  proširenosti zloupotrebe tog antibiotka. Za proveru terapijske efikasnosti treba ponoviti analizu stolice na Bh najranije mesec dana nakon zavšetka lečenja. Efikasnost metronidazola u terapiji blastocistoze, čak do 100%, te se zbog visoke stope eradikacije smatra se lekom izbora u lečenju blastocistoze.

 

 

 

Ključne reči:

Blastocistis hominis, blastocistoza, metronidazol, dete, adolescent

 

 

Abstract

 

Blastocystis hominis (Bh) is the most outspread protist on our planet, but also the most controversial. Infection Bh starts by digestion of the eaten food or liquid which has been contained by a cyst form Bh. After swallowing, from the cyst they grow (progress) in the colon of the human, with a vacuolar form of a protest. Oral transmission is the most common way of spreading the infection. The disease caused by Bh on humans is called blastocystisis. The most common clinical manifestations of blastocystosis are gastrointestinal, but other non-specific signs may also be present. Blastocystosis therapy is necessary in immunocompromised children, regardless of whether it is symptomatic and asymptomatic, but also in immunocompetent individuals with a symtoms. The most commonly recommended antibiotic for the treatment of blastocystosis is metronidazole for 10 days, administered orally. In case of gastroenterological disorders, it is advised to change the way metronidazole is administered and the parenteral route of administration. Resistance to antibiotics is conditioned by genetic characteristics of Bh, since different subtypes Bh have different susceptibility to drugs, but also geographical position, because resistance to certain antibiotics is different in different parts of the world, in line with the extent of abuse of that antibiotic. To check the therapeutic efficacy, it is necessary to repeat the analysis of the stool on Bh at the earliest one month after the treatment has finished. The efficacy of metronidazole in the treatment of blastocystosis, up to 100%, and due to the high rate of eradication it is considered a medication choice in the treatment of blastocystosis.

 

 

Key words:

Blastocystis hominis, blastocystosis, metronidazole, child, adolescent

 

 

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PDF Stojšić M. and Kolarović J. • MD-Medical Data 2017;9(3): 177-180

 

 

 

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