***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: We examined the therapeutic effects of albendazole compared to metronidazole in 120 patients with giardiasis in Hamdan . Patients were r and omized to receive albendazole ( 400 mg , once daily for 5 days ) or metronidazole ( 250 mg , 3 times a day for 5 days ) . Demographic data of the patients , results of stool examination for Giardia trophozoites before and after treatment , and drug side-effects were recorded . After treatment 6 ( 10.0 % ) of the albendazole group had trophozoites compared with 14 ( 23.3 % ) of metronidazole group ( P < 0.05 ) . Patients in the albendazole group had fewer side-effects while 43.3 % of the metronidazole group experienced a metallic taste and 35.0 % experienced loss of appetite .  Albendazole is an easy , safe and effective treatment for giardiasis An open , r and omized study was carried out with 100 children to compare the efficacy and security of albendazole and metronidazole to eradicate Giardia lamblia . We included 100 patients in primary school age with giardiasis confirmed by parasitoscopic test who had not received treatment during the 2 previous months . A complete clinical study was performed . By using an aleatory code , the children were distributed in 2 groups : A and B. The clinical data was corroborated and the following tests were made : cell blood count , blood chemistry , direct and concentrated coproparasitoscopic study . Both groups were given an antiparasite treatment consisting of albendazole for group A or metronidazole for group B. Clinical , parasitological and blood controls were conducted before , during and after the treatment . A therapeutic efficacy of 94 % and 98 % for group A and B , respectively , was found . We concluded that albendazole and metronidazole are equally effective in a 5 days treatment period , but some undesirable effects may occur with metronidazole AIM To investigate the efficacy and tolerability of albendazole and metranidazole treatment in giardiasis . METHODS The open comparative r and omized trial was carried out prospect ively from December 1999 to July 2001 in Duzce City of Turkey . The diagnosis was based on the presence of signs and symptoms compatible with giardiasis including a positive stool examination of giardia cysts or trophozoite .  Metranidazole group consisted of 29 patients and was given metranidazole 500 mg , three times a day for 5 d and  albendazole group was consisted of 28 patients and was given albendazole 400 mg/d for 5 d. RESULTS There were no significant differences in demographical and therapeutical effects and patient 's compliance between both groups . But side effects were seen more in metranidazole group than in albendazole group . CONCLUSION Albendazole is as effective as metranidazole in adults ' giardiasis . Albendazole has less side effect potentials than metranidazole in the treatment of giardiasis Therapy with metronidazole is the recommended option in giardiasis . However , some clinical trial reports suggest the appearance of drug resistance to explain therapeutic failure . Several investigations have been carried out on the effect of probiotic microorganisms for preventing or treating gastrointestinal diseases , but little is known about their efficacy against protozoal infections . The principal objective of our study was to evaluate the efficacy of Saccharomyces boulardii against Giardia lamblia infections . A double-blind , placebo-controlled study was carried out on adult patients with giardiasis . Group 1 ( 30 patients ) included metronidazole 750 mg 3 times daily along with S. boulardii capsules ( 250 mg b.i.d . orally ) for 10 d while group 2 ( 35 patients ) was treated with metronidazole 750 mg 3 times daily and with empty capsules as placebo for 10 d. Patients were re-examined at 2 and 4 weeks after treatment , and stool examinations were performed . At week 2 , G. lamblia cysts were detected in 6 cases ( 17.1 % ) of group 2 and none in group 1 . At the end of the fourth week , presence of the cysts continued in the same 6 cases in group 2 ( control group ) . These findings indicated that S. boulardii may be effective in treating giardiasis when combined with metronidazole therapy Giardia lamblia is a flagellate protozoan that produces symptoms by infecting the small bowel and biliary tract in the trophozoite form . Diagnosis is currently established by microscopic visualization of the organism in appropriate intestinal contents ( stool , small-bowel contents , or biopsy specimen ) . Adult patients with diarrhea and one or more enteric symptoms may be enrolled in clinical trials of new drugs for the treatment of giardial disease . A r and omized , double-blind , active-concurrent-control design is recommended . Post hoc stratification by age , immune status , chronicity of disease , and ease of establishing diagnosis ( organism load ) may be performed . Microbiological assessment 48 hours to 7 days after the completion of therapy is paramount for determining final outcome Fifty-five patients , 51 males and 4 females heavily infected with Giardia lamblia were treated with a single 2 g dose of tinidazole ( four tablets ) ; 53 were cured . Of 20 other infected patients kept under the same conditions and given four placebo tablets , 18 continued to pass cysts or trophozoites in the stools during the whole 3- to 4-wk follow-up period in hospital . There were no side effects attributed to the drug The efficacy of single-dose ornidazole versus seven days metronidazole in the treatment of giardiasis was tested in a r and omized study of 75 Kibbutzim children in Israel . All the children treated were clinical ly cured , and the parasites disappeared from stool examinations after the first follow-up . By the end of the study ( 21 days after the beginning of treatment ) , all the patients remained free of symptoms , but cysts ofGiardia lamblia were found in the stools of three children from the ornidazole group ( p=0.24 ) . The possibility of treatingGiardia lamblia with ornidazole in a single dose , with results similar to those obtained with a seven-day course of metronidazole , makes this drug a good alternative in the treatment ofGiardia lamblia in children , especially if compliance is not assured One hundred children were entered into a r and omized study to compare the efficacy and safety of furazolidone and metronidazole when given in liquid suspension for treatment of giardiasis . The study was conducted between May 1985 and February 1986 . Dosages were calculated on the basis of body weight , and treatment lasted 10 days . Clinical diagnosis of giardiasis was confirmed by the presence of Giardia cysts in stools . Children were excluded from the study if stool culture was positive for pathogenic bacteria . Eighteen of the 100 children were withdrawn from the study because of noncompliance with the protocol . Of the 82 remaining patients , 37 received furazolidone and 45 metronidazole . No statistically significant differences in efficacy between treatments were found . With the exception of one case of urticaria , which occurred in a patient who received metronidazole , both drugs were well tolerated . In this study , furazolidone and metronidazole were equally safe and effective in treating children with giardiasis A r and omized controlled trial was carried out to study the efficacy of combined albendazole and praziquantel in the treatment of giardiasis in school-age children . Eighty-four children were r and omly allocated to 3 groups : group 1 ( n = 31 ) albendazole 400 mg combined with praziquantel 20 mg/kg ; group 2 ( n = 26 ) albendazole 800 mg as a single dose ; group 3 ( n = 27 ) tinidazole 50 mg/kg as a single dose . The treatment was considered curative when Giardia was not found in two consecutive stool sample s. The parasitological cure rate was 74.2 % for combined single-dose albendazole-praziquantel , 50 % and 92.6 % in the albendazole and tinidazole groups respectively ( p = 0.0023 ) . There was no statistically significant difference between the cure rates of the combined regimen and tinidazole ( p > 0.05 ) . This combined regimen was considered safe , with only minor side-effects being observed . Of the single-dose regimens , tinidazole still achieves the highest parasitological cure rate for giardiasis . The albendazole-praziquantel combined regimen may be an alternative single-dose therapy for giardiasis in children , especially as this combination will eradicate common intestinal protozoa and co-existing helminths . Whether the dosage of this combination treatment should be adjusted for G. intestinalis remains to be established by further study The therapeutic effects of quinacrine ( Atabrine ) and metronidazole ( Flagyl ) were compared in a 3-year prospect i ve study of 160 infants and children ( 86 boys and 74 girls ranging in age from 4.5 months to 13 years ) with giardiasis . The most common symptom was recurrent abdominal pain . In each study group stool examinations were done 5 days , 1 month , and 6 months after treatment . There were no treatment failures with metronidazole , whereas four of those treated with quinacrine had positive stools 5 days after treatment , indicating possible failure . There were no recurrences at 1 month ; after 6 months , however , Giardia infection was found in 13 % of both treatment groups . These recurrences were seen mainly in children from families with other infected members . Considering the low failure rate , the minimal side effects , and the relatively more tolerable flavor , metronidazole seems to be preferrable in the treatment of giardiasis . A dosage of 15 - 25 mg/kg a day for 5 days is recommended The adverse effects and treatment failures to some of the currently recommended drugs for giardia infection have given rise to the need for alternative antigiardial agents . In an open , r and omized parallel group study , the safety and efficacy of albendazole was compared with that of metronidazole for the treatment of giardiasis in children . Sixty two children aged between 2 - 12 years were r and omized to receive either albendazole suspension 400 mg daily for 5 days or metronidazole suspension 7.5 mg/kg thrice daily for 5 days . The mean days required for cure , as evident by absence of cysts and /or trophozoites in the stool specimen , was 3.7 + 1.4 and 4.5 + 1.1 days , respectively for children on albendazole and metronidazole therapy . Six children on metronidazole therapy developed anorexia 2 to 4 days after the treatment .  Albendazole  proved as effective as metronidazole in the treatment of giardia infection in children with the added advantage of absence of anorexia The CONSORT ( Consoli date d St and ards of Reporting Trials ) statement is used worldwide to improve the reporting of r and omized , controlled trials . Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . The protozoan parasite Giardia lamblia is a major cause of waterborne enteric disease worldwide . Lectins are proteins that bind to carbohydrate ( sugar ) moieties . Potential targets for lectins are found on the surface of most single-celled organisms . Modest concentrations of wheat germ agglutinin ( WGA ) have been shown to inhibit G. lamblia excystation and trophozoite growth in vitro and can reduce cyst passage in mice infected with the closely related protozoan parasite , G. muris . Commercial preparations of wheat germ ( WG ) contain 13 - 53 microg of WGA per gram . We performed a double-masked , placebo-controlled study of dietary supplementation with WG in 63 subjects with giardiasis in Montreal and Lima ( 25 asymptomatic patients passing cysts ; 38 patients with symptoms ) . Asymptomatic subjects received WG ( 2 g , 3 times a day ) or placebo ( cornstarch , 2 g , 3 times a day ) for 10 days , followed by metronidazole ( 250 mg 3 times a day ) for 7 days . Symptomatic subjects received metronidazole ( 250 mg 3 times a day ) plus either WG or placebo for 7 days . Stool specimens were collected every day ( Montreal ) or every other day ( Lima ) for 10 days and on Day 35 for microscopic examination and coproantigen determination . Subjects kept a diary of symptoms for 10 days after recruitment . In asymptomatic subjects , both cyst passage and coproantigen levels were reduced by approximately 50 % in those taking WG compared with the placebo group ( P < 0.01 and P = 0.06 , respectively ) . In symptomatic subjects , cyst passage and coproantigen levels fell precipitously in response to metronidazole therapy , and there were no clinical ly important differences between those receiving supplemental WG or placebo . However , symptoms appear to have resolved more rapidly in the subjects taking WG in addition to metronidazole . The WG supp 
    Output:
    
Albendazole may be of similar effectiveness to metronidazole , may have fewer side effects , and has the advantage of a simplified regimen .