Balantidiasis

Treatment

The drug usually used is tetracycline, but metronidazole works well as an alternative althought it is not uniformly effective. Iodoquinol, puromycin, and nitazoxanide are adequate methods for treatment.

Tetracycline prevents growth of the parasite through inhibition of protein synthesis by binding to the 30S and 50S ribosomal subunits. Use 500 mg PO qid for 10 days for adults.

Metronidazole acts primarily against the trophozoite form and limited activity against the encysted form.

During treatment, be aware of volume replacement and electrolyte replenishment in patients with severe diarrhea.

 

Prevention

Increasing hygiene as well as sanitation will help prevent spread of the disease since transmission occurs through ingestion of contaminated food and water. Thus purification of drinking water is essential. Proper food handling and cooking can also help to prevent infection. Decreasing exposure to pig or pig excrement will reduce risk of infection.

There is currently no vaccine to prevent infection, and reinfection may occur in individuals had previously been infected.