Background: The aim of this study was to determine the effect of metronidazole in patients who did not cure after treatment with triclabendazole, in Guilan (Northern Province of Iran).
Material/methods: Patients, who passed fasciola egg in stool and had positive serum anti fasciola antibody (ELISA), at least three months after treatment with triclabendazole, were enrolled and received 1.5 g/day metronidazole orally for three weeks. Two months and 12 months after end of therapy, stool examination in 3 consecutive days and serum anti fasciola antibody were performed. Frequency of patients with negative serology for fasciola and/or absence of fasciola egg in stool were determined. Chi-square test was used and P value <0.05 was considered significant.
Results: Forty-six patients, 26 females and 20 males, were enrolled with mean (+/-SD) age of 34.6(+/-9.8) years. Three patients excluded because of drug side effect and poor compliance. Two months after end of therapy, stool exam became negative in 35 patients and in 31 patients became negative both in serology and stool examination. (Difference in response to treat between age groups and genders was not significant). All patients with abdominal pain became pain free after therapy. Most frequent side effects were metallic taste in 14 (30.4%), headache in 8 (17.4%) and nausea in 6 (13%). 12 months after end of therapy, 28 out of 35 patients were examined again and all were negative both in serology and egg in stool examination.
Conclusions: Metronidazole, 1.5 g/day for 3 weeks, seems to be an effective, available, well-tolerated alternative for treatment of human fascioliasis.