Treatment of Cryptosporidium species infection in patients who are immunocompetent

In patients who are immunocompetent or who do not have significant immune compromise, infection with Cryptosporidium species (cryptosporidiosis) usually causes a self-limiting gastroenteritis; symptoms can persist for weeks or months. Antimicrobial therapy is usually not indicated. Rehydration and antidiarrhoeal drugs are the mainstay of treatment (see Approach to managing acute gastroenteritis).

For patients who are immunocompetent with severe diarrhoea caused by Cryptosporidium species or those with symptoms not improving after 2 weeks, consider:

nitazoxanide orally, 12-hourly for 3 days1 nitazoxanide nitazoxanide nitazoxanide

adult or child 12 years or older: 500 mg. For dosage adjustment in adults with kidney impairment, see nitazoxanide dosage adjustment

child 1 to 3 years: 100 mg2

child 4 to 11 years: 200 mg3.

Adults with undiagnosed HIV infection may present initially with persistent cryptosporidiosis. Persistent cryptosporidiosis is an indicator condition for HIV testing4. If persistent cryptosporidiosis is identified, offer HIV testing, regardless of whether the patient has behavioural or epidemiological risk factors for HIV infection.

1 Nitazoxanide is not registered for use in Australia but is available via the Special Access Scheme.Return
2 This dose applies to the oral suspension; the film-coated tablet formulation is not bioequivalent.Return
3 This dose applies to the oral suspension or dispersible tablet; the film-coated tablet formulation is not bioequivalent.Return
4 Indicator conditions for HIV testing are conditions that are seen in people with HIV infection (including undiagnosed infection), conditions that share a transmission route with HIV (eg sexually transmissible infections), or conditions for which management is altered in people with HIV infection (eg tuberculosis).Return