Cryptosporidium infection in solid organ transplantation

Table 3 Management of Cryptosporidium infections

Ref.	Treatment regimen (length)	Changes in immunosuppression	Resolution of symptoms	Graft loss	Death
Abdo et al[15]	Rifampin (3 wk)	Temporary lower level of TAC	Resolved	No	No
Acikgoz et al[23]	Spiramycin + NTZ + PAR (4 wk)	Switch from MMF to AZA	Resolved	No	No
Arslan et al[10]	N/A	N/A	N/A	N/A	N/A
Bandin et al[8]	NTZ (4 wk) (2) NTZ (2 wk) (5)1	MMF switched to AZA (3)1 MMF reduced (3)1 TAC switched to sirolimus (1)1	Resolved	No	No
Bhadauria et al[3]	NTZ (13) (16-60 d) NTZ + fluoroquinolone (21) (16-60 d)	MMF → AZA (3) TAC → CsA (8) Reduction of immunosuppression (11)	Resolved microbiologically (83%)	Yes (3)
Bonatti et al[5]	AZM (14-21 d) (2)1 AZM + NTZ (6-18 d) (2)1 NTZ (14-16 d) (2)1 AZM (5 d) + NTZ + TMP/SMX (14 d) (1)1 AZM + PAR(14d) (1)1	MMF stopped (4)1 MMF reduced (1)1	Resolved	No	No
Campos et al[18]	Spiramycin → PAR (6 mo) PAR(2)	N/A	Resolved	No	No
Chieffi et al[30]	N/A	N/A	N/A	N/A	N/A
Clifford et al[21]	N/A	N/A	Resolved	No	No
Delis et al[16]	AZM (7 d) + PAR (21 d) (2)1 PAR (14 d) (1)1 PAR (21 d) (1)1	Stopped (1/4)1 TAC reduced (1/4)1	Resolved	No	No
Franco et al[100]	Spiramicin 10 d	MMF → Aza Stopped Aza	Resolved	No	No
Frei et al[6]	PAR (4 wk)	No	Resolved	No	No
Gerber et al[17]	AZM (3 wk) (1)1 PAR (2-3 wk) (2)1	No	Resolved	No	No
Hong et al[9]	NTZ (4 wk) PAR + AZM (5 wk), oral human immunoglobulin (5 d)	TAC reduced MMF stopped and AZT started	Resolved	No	No
Krause et al[4]	NTZ (5-24 d)	No	Resolved	No	No
Ok et al[19]	N/A	N/A	N/A	N/A	N/A
Pozio et al[14]	AZM (1 wk) + PAR (3 wk) AZM + PAR (1 yr 7 mo)	N/A	Resolved	No	No
Rodríguez Ferrero et al[7]	AZM + PAR (14 d) NTZ (6 d)	MMF and TAC reduced	Resolved	No	No
Tran et al[12]	PAR (4 wk)	Sirolimus discontinued	Resolved	No	No
Udgiri et al[13]	Spiramycin (10 d) (2)1	No	Resolved	No	No
Vajro et al[24]	None	No	Resolved	No	No
Ziring et al[11]	PAR + AZM	N/A	Resolved	No	No

¹The number of patients; TAC: Tactolimus; MMF: Mycophenolate mofetil; AZT: Azathioprine; S: Steroids; AZM: Azithromycin; NTZ: Nitazoxanide; PAR: Paromomycin; N/A: Not available; TMP/SMX: Trimethoprim/sulphamethoxazole.