5 best cures for giardiasis

*Overview of the best according to the editors of Healthy Food Near Me. About selection criteria. This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.

This material is devoted to the modern treatment of giardiasis in children. Since giardiasis practically does not occur in healthy adults, or is very rare, parents will most likely study this material before purchasing drugs for their children and treating them. If a competent specialist is engaged in the treatment of giardiasis, then there is no need to study additional material on the Internet. Dad or mom will follow the instructions of the pediatrician, infectious disease specialist, and purchase the appropriate medicine.

Therefore, the study of materials on the Internet is usually carried out by those parents who treat their children on their own. They should be warned against this practice, because they have a poor idea of ​​the indications for prescribing certain drugs, cannot find effective dosages, do not know how to organize the entire treatment process, and cannot imagine the correct criteria for cure. All this is done by a doctor. However, at present, in the context of coronavirus infection, self-isolation, the danger of visiting crowded clinics, except for emergency, it makes sense in an article about giardiasis. In addition to information about modern drugs, it is necessary to give useful information that may be important to parents. If you treat yourself, then do it right.

What is giardiasis?

By themselves, Giardia has nothing to do with helminths, since they are unicellular parasites, protozoa. Like many protozoa, they can be in a vegetative form (growing, mobile), no larger than 0,02 mm, and in the form of cysts that reproduce. Vegetative forms of parasites live and multiply in the small intestine, bile ducts, divide by simple, asexual cell division in half. And when they enter the unfavorable environment of the large intestine, they turn into cysts and are excreted in the feces. Cysts are able to exist for a long time in adverse conditions, and then enter the human body and turn into vegetative forms.

Giardia are very primitive, they attach themselves to the villi of the intestines and suck up our food gruel with their whole body, with their whole cell. They love very much when their owner eats sweet and starchy foods, they begin to actively share. They cause harm to health with the help of their toxins and waste products. They can also act remotely: some allergy symptoms, asthma in a child may well be associated with giardiasis.

You can get infected through unwashed hands, unwashed water, dirty fruits and vegetables, contact with animals (giardia parasites in dogs and cats), sick children and household items if they have cysts. In order for the disease to develop, 10-15 cysts are enough, and infection is possible if there is low acidity of gastric juice, or gastritis with low acidity.

Giardiasis is quite insidious. It can be hidden, atypical, there may be a transient carriage of Giardia, and the symptoms, even in the case of a vivid clinical picture, may be different.

There are no symptoms that accurately indicate Giardia. In some cases, sometimes there is an erased, or subclinical form, but giardiasis is already manifested by its complications, which also do not have any specificity. It can be hives, Quincke’s edema, inflammation of the joints (arthritis), or even malnutrition and protein-energy malnutrition.

When should giardiasis be suspected?

Giardiasis has extensive symptoms, but nevertheless, taken separately, without specificity, signs, in combination with others, can lead to certain thoughts. The child should be examined for giardiasis if these symptoms and signs are present:

1. prolonged, chronic diarrhea or diarrhea without signs of severe intestinal infection;

2. newly established diagnoses of duodenitis, pancreatitis in a child, complaints of bloating, poor tolerance to fatty foods;

3. the appearance of persistent nausea without other symptoms;

4. often complains of lack of appetite, belching, heartburn, increased salivation, pain in the right hypochondrium, headache, or even joint pain;

5. attacks of morning weakness, lethargy, lightheadedness, dizziness, episodes of low blood pressure;

6. the child does not gain weight, and even loses;

7. malnutrition may occur, drowsiness occurs, there is no desire to wake up in the morning, go to school or kindergarten, do poorly at school;

8. mood is depressed, which is especially combined with exacerbation of gastrointestinal disorders;

9. skin problems appear: itching, hives, signs of eczema, or neurodermatitis;

10. the child constantly catches a cold, frequent acute respiratory viral infections occur, doctors diagnose “immunodeficiency”, the diagnosis of “chronic obstructive bronchitis”, or even bronchial asthma, allergists diagnose “allergies of unidentified allergies”;

11. in the blood, eosinophilia occurs above 10%, which is persistent;

12. subfebrile temperature appears, the cause of which cannot be found in any way.

There are also those symptoms that the child will not tell you about, but an attentive parent may notice that something is wrong with the baby. These are signs such as plaque on the tongue, the appearance of fatty, frothy stools mixed with mucus, which has a fetid odor. The child develops pallor, and the skin of the face and nose will be especially pale. Peeling of the palms, symptoms of cheilitis may appear. Cheilitis is an inflammatory lesion of the red border of the lips, when its peeling, dryness and cracks occur, seizures occur.

How to look for Giardia?

You need to forget about all the “fashionable blood tests.” Giardia are in the intestines, and their toxins are in the intestines, Giardia does not leave any structural antigenic complexes in the blood, and antibodies to Giardia are not produced in the blood. Therefore, all diagnostics is based on the detection of either the parasites themselves or their antigens in the gastrointestinal tract. In this case, the “gold standard” is the detection of Giardia cysts in the feces. This is the easiest and most convenient way for the child to diagnose.

Giardia cysts have structural differences from cysts and eggs of other parasites, and it is impossible to confuse them with any other pathogens of parasitosis and helminthiasis. Therefore, if an experienced laboratory assistant has found at least one cyst under a microscope in the analysis of fresh cola, or feces with a preservative, then the diagnosis is clear.

However, it is not always possible to detect Giardia cysts in feces and in large numbers. This is likely only if Giardia enters the large intestine in large numbers, where they have unfavorable conditions for the existence of vegetative forms. But they try not to do this, and try to stay in the upper gastrointestinal tract, where there are comfortable conditions and a lot of food. Sometimes they are not in the duodenum either, since they are all in the bile ducts.

Therefore, the second “gold standard” of diagnostics is the detection of vegetative forms in the duodenal contents. For this, the child needs to undergo duodenal sounding, although for many this study is very, very unpleasant.

Modern diagnostic methods make it possible to determine Giardia DNA in feces by PCR. This is a method with high sensitivity and specificity. Finally, if esophagogastroduodenoscopy (EFGDS) is performed with a biopsy of the duodenal mucosa, then a real-time PCR reaction can be performed with this biopsy.

The enzyme-linked immunosorbent assay, ELISA, has the least diagnostic value, but even in this case, it is necessary to look for antibodies to Giardia not in the blood, but also in the feces, or in biopsies of the duodenal mucosa. But in the event that the child’s immunity is reduced, then the ELISA may show a false negative result.

It is possible to donate feces for cysts several times, and the period of time when the above symptoms are most pronounced will be most likely to detect parasites. There are no other ways to detect Giardia today.

5 best cures for giardiasis

Pharmacotherapy giardiasis

Before listing modern drugs that cure giardiasis, it must be said that they have different activities. For example, the anthelmintic drug albendazole also affects Giardia, and the drug that treats anaerobic infection, metronidazole, also has a detrimental effect on these protozoa. However, they have too wide spread of efficiency. Albendazole is effective in at least 33% of cases, as a maximum – in 100%, and metronidazole – from 12 to 70%.

But you can not list all the drugs for the treatment of giardiasis in a row, this is a gross mistake. There are 3 main groups of drugs that are used in the treatment of giardiasis. This is the starting group with which treatment is prescribed, alternative means if the drugs of the first group do not help, and finally, reserve drugs that are prescribed last.

For each drug, the INN, that is, the international non-proprietary name, will first be indicated. Then – the name of the original drug, if known. Further, if any, there will be a list of commercial copies, trade names, or generics. Prices will also be shown. The price range for each drug will be relevant for pharmacies of all forms of ownership in the Russian Federation for April 2020.

The inclusion of drugs in the list is dictated by federal and national recommendations of gastroenterologists, infectious disease specialists and pediatricians for the treatment of giardiasis in children. First, we list the basic means of the main group, with which the treatment of uncomplicated forms of giardiasis in children begins.

base group

In addition to the three drugs listed below, the base group usually also includes furazolidone. But the effectiveness of furazolidone is lower than all other means. This drug is considered ancient, and already outdated, and if possible, it is necessary to use either metronidazole preparations, or Nifuratel, or Nemozol. Albendazole, unlike other drugs, is available not only in the form of conventional tablets, but also in the form of chewable tablets, and in the form of a suspension, which is very convenient to give to babies.

Nifuratel (McMirror)

Rating: 4.9

Macmirror or Nifuratel is a good synthetic antibacterial drug from the group of nitrofurans, which, in addition to antimicrobial, also has antifungal, and so we need antiprotozoal (against protozoa) action. With high efficiency, it has low toxicity, which is very important for its use in pediatric practice. In addition to Giardia, it is highly active against intestinal infections, trichomonas and candidiasis. It is also used to treat Helicobacter pylori infection.

In the case of giardiasis, Macmirror should be used as follows: 20 mg / kg body weight per day in 2-3 doses, in a child under 12 years old, and from 800 to 1200 mg per day in 2-3 doses in children over 12 years old, and for adults . The duration of the course of treatment with Macmirror is from 7 to 10 days. Release form: 200 mg tablets, and for a package of 20 tablets you will give 930-1040 rubles. Macmirror is produced by the Italian company Doppel.

Advantages and disadvantages

Macmirror is well tolerated, it is a drug with low toxicity, the main thing is not to make a mistake with the dose. Side effects may include nausea and vomiting, bitter taste in the mouth, diarrhea, skin rash, and itching. That is, symptoms that are little different from severe giardiasis. The drug is contraindicated only in case of hypersensitivity, so it can be safely recommended as a first-line drug for the treatment of confirmed giardiasis.

Albendazole (Nemozole)

Rating: 4.8

This medicine is produced by the Indian company Ipka in three versions:

1. suspension that contains 100 mg of the active ingredient in 5 ml (in a 20 ml vial, i.e. 400 mg in a vial). The suspension costs no more than 200 rubles;

2. a package of one chewable tablet is produced, also weighing 400 mg, the price of such 1 chewable tablet is from 160 to 240 rubles;

3. Nemozol is produced in ordinary tablets, also 400 mg each, in a package of 5 pieces, the cost of such a package is from 680 to 800 rubles.

Surprisingly, this drug was created not at all to act on unicellular protozoa, but on multicellular worms. Its effect is associated with the destruction of cytoplasmic channels in the intestines of helminths, but it turned out that this drug is also highly active against Giardia. The average therapeutic dose for giardiasis in children under 12 years of age is 10-15 mg per kilogram of body weight once a day for a week. If the child is over 12 years old and weighs less than 60 kg, then he is given one 400 mg tablet per day. If he is over 60 kg, then he is given 2 tablets per day, the daily dose is 800 mg.

Advantages and disadvantages

As mentioned above, the big plus of albendazole is its ability to give young children with giardiasis in the form of a suspension. The second big plus is its low price. The relative minus is the presence of a single manufacturer. All three forms are produced by the Indian company Ipka, and no other variants of albendazole have yet been provided on the Russian market. Therefore, in the event of supply problems, or interruptions, there will be great difficulties with the availability of the drug. In addition, the remedy can still be taken against worms, that is, helminths, and this is its main indication for use. The drug has some side effects: this is a change in liver function tests, an increase in transaminase activity, leukopenia, headache, fever. However, these effects are dose-dependent and are most pronounced in cases of severe illness, such as echinococcosis, when the drug is taken for a long time.

Metronidazole (Flagyl, Klion, Trichopol)

Rating: 4.7

Unlike previous drugs, metronidazole has many trade names, or generics. But still, we advise you to purchase not just “metronidazole”, but a drug that has really proven itself well. For example, this is the Clion of the Gedeon Richter company, known for its centuries-old pharmaceutical traditions from Hungary, or use Flagyl, the French production of Sanofi. Even the French Flagil, one of the best on the market, is inexpensive. For a pack of 20 tablets of 250 mg, you will pay no more than 130 rubles.

The list of indications for the use of Flagyl, or metronidazole, is very wide. In addition to giardiasis, there are many different microbial diseases that are caused by anaerobic flora, urogenital trichomoniasis, and surgical infections. With giardiasis, children should be prescribed it depending on age. Dosage – 15 mg per kilogram of body weight per day, divided into three doses:

1. Children under one year – 125 mg per day;

2. from two to five years of age 250 mg per day;

3. from five to ten years – 375 mg per day;

4. from ten to fifteen years – 500 mg per day;

5. older than fifteen years – from 750 to 1000 mg per day.

6. The duration of the course of treatment is 5 days.

Advantages and disadvantages

The advantage of metronidazole is its rather low price, but the disadvantage may still be insufficiently high activity, and the presence of some side effects, for example, a metallic taste in the mouth, nausea, abdominal pain, leukopenia. Therefore, it is recommended to prescribe Flagyl from the basic group of drugs only if it is not possible to use the drugs described above, but still this does not mean that it is worse than others. If giardiasis will be treated by a young man who has already begun to drink alcohol, then treatment with metronidazole is categorically contraindicated. It causes a teturam-like effect, and it is strictly forbidden to combine it with alcohol.

Alternative group

Medicines from the alternative group are prescribed if for some reason the drugs from the first group turned out to be ineffective. But, of course, only a doctor should decide this, and only after monitoring the treatment. The second group includes the drug tinidazole, aka Fazizhin, as well as Enterol, which, in fact, is not an antimicrobial and antiprotozoal agent, but is more like a probiotic, since it contains a pure yeast culture. Unfortunately, a highly effective drug from this group, nimorazole, also known as Naxodzhin, is temporarily not available on the Russian market, it cannot be purchased anywhere in our country in 2020, but still it exists, and therefore we mention it.

Tinidazole (Fazigin)

Rating: 4.9

It is also currently not possible to obtain the original imported Fazizhina drug in Russia, so we will be content with the domestic analogue, which is produced by the Ozone company. Four tablets of 500 mg will cost from 50 to 105 rubles.

Tinidazole is a synthetic antibacterial drug with high activity against protozoa. They are successfully treated with severe forms of amoebic dysentery, including amoebic liver abscess, trichomoniasis, severe forms of cutaneous leishmaniasis, and including giardiasis. Since in the composition of the mixed microbial flora in severe conditions and purulent wounds, with peritonitis, lung abscess, there may be contamination with protozoa, Tinidazole is also indicated for the treatment of these serious diseases. The substance is a derivative of nitroimidazole, it is able to penetrate well into fats (the lipid bilayer of protozoan membranes), and there it destroys the hereditary material of parasites.

Tinidazole should be prescribed to children under 12 years of age at a dose of 50 or 75 mg per kg of body weight per day, divided into 3 doses. Children over 12 years of age are given 2 g once a day. Tinidazole is available in 500 mg tablets, respectively, children over 12 years old are given 4 tablets at once. The course of treatment is from 5 to 10 days.

Advantages and disadvantages

The original tinidazole, or Fazizhin, is a highly effective drug. Since the domestic, Tinidazole produced by Ozone, was not compared with the original, it is impossible to say how good it is. But even if we consider it as effective, then contraindications must be taken into account. These are children with pathology of the red bone marrow, hematological patients, as well as children with pathology of the central nervous system of an organic nature: cerebral palsy, encephalopathy, epilepsy. It is necessary to take into account the side effects of tinidazole. These are headache, dizziness, weakness, loss of appetite, dry mouth and a metallic taste. It is important to understand that when the duration of treatment is longer than 7 days, it is necessary to control peripheral blood in order to avoid inhibition of the red bone marrow. Older boys, as well as girls, are strictly forbidden to drink alcoholic beverages during treatment, as nausea, vomiting and intestinal colic may occur. But do not be afraid of the darkening of the urine, which causes the use of tinidazole, this is normal.

Enterol (Saccharomycetes)

Rating: 4.8

As mentioned above, this medicine stands a little apart. It is sold in capsules, 250 mg each, and a pack of 30 of these capsules will cost from 520 to 700 rubles. Enterol is a French drug manufactured by Biocodex. Capsules contain a light brown powder with a characteristic smell of yeast, it is a lyophilisate of varietal Saccharomycetes.

The drug is positioned as an antidiarrheal drug, and Saccharomycetes are probiotics. But, having entered the intestines in large numbers, they quickly enter into antagonism against pathogenic and opportunistic flora, and this applies not only to microorganisms, but also to the simplest: dysenteric amoeba and giardia. The drug is able to improve the enzymatic function of the intestine. But Enterol cannot treat dysbacteriosis, since this particular type of yeast is not found in a healthy person. An increasing amount of swallowed yeast passes through the intestines unchanged, they do not leave any colonies, and are completely eliminated from the body within 5 days after stopping treatment. Therefore, Enterol can be considered a kind of “biological brush”.

It is necessary to use this medicine for giardiasis in children from one to three years of age – 1 capsule 2 times a day, from the age of three – 1 or 2 capsules 2 times a day. Naturally, the contents of the capsules for babies are poured into a drink of warm or room temperature, and drunk. A hot drink should not be used so that the live yeast does not die. Children from 12 years of age are prescribed the same dosage: one capsule 2 times a day. The duration of the course of treatment in children under 3 years old is five days, and from the age of three years – from 7 to 10 days.

Advantages and disadvantages

The advantages of Enterol in its good tolerance, the absence of a chemical substance as such, it has a healing effect on the body as a whole, improves bowel function, and has few side effects. This is constipation, increased gas formation, and occasionally hives are possible. Also, Enterol should not be prescribed to babies under 1 year old. Otherwise, it is a good second-line drug, and it can be combined with antiprotozoal drugs from the first group.

Reserve drugs

Finally, we proceed to the description of reserve preparations. There are few of them: Tiberal or ornidazole, known to everyone, the rest are little known, but this is good. That’s the way it should be. Antimicrobial, antiprotozoal reserve drugs should be used infrequently so that protozoa do not develop resistance to them. Of course, protozoa do not divide in half as often as microorganisms. They do not have a new generation as often as microbes do, mutations do not appear so often, among which there may be useful ones for them, which determine drug resistance.

But still, it is necessary to follow certain rules in the treatment. Furazolidone, which was very effective in the 10s and 15s against giardiasis, now helps much less. Giardia have learned to deal with it. Therefore, if you constantly use Tiberal as a highly effective drug against giardiasis, then soon, in XNUMX-XNUMX years, these protozoa will become resistant to it.

Ornidazole (Tiberal, Gyro, Dazolic, Quinizol, Lornisol, Ornicid)

Rating: 4.9

So, Tiberal is now very widely used for the treatment of giardiasis, and it is gradually losing its right to be a reserve drug, and this is very sad. Ornidazole is indeed a drug that mainly works against protozoa, but it also has antibacterial, antimicrobial activity. It, like Fazizhin, is a derivative of nitroimidazole, and penetrates through the lipid layer of the membranes of protozoa, disrupting their hereditary material. In addition to Giardia, Tiberal is indicated in the case of trichomoniasis, amoebic dysentery, and some anaerobic processes. In addition to giardiasis, Tiberal is indicated in case of severe intestinal lesions with amoebic dysentery, amoebic liver abscess, and the prevention of postoperative complications. This medicine should be used in children weighing less than 35 kg at 40 mg per kilogram of body weight per day, and for children over 12 years old, 1500 mg per day, or 1,5 g once, is given. Treatment continues for one to two days. Tiberal is produced by the Austrian company Sandoz, and one pack of 10 tablets of 500 mg each will cost 630 – 760 rubles.

Advantages and disadvantages

The advantages of Tiberal are a short course of treatment, high efficiency, but Tiberal can also have side effects. These are nausea, heartburn, drowsiness and dizziness. Headache and diarrhea are also possible. Tiberal is contraindicated in case of acute neurological pathology in children.

Secnidazole (Secnidox)

Rating: 4.8

This medicine is used much less frequently than Tiberal, and rightly so, a reserve is a reserve. Secnidazole is produced in the UK and also belongs to the nitroimidazole derivatives. In general, all the most highly active antiprotozoal agents belong to imidazole derivatives. Seknidoks is no exception: it is a highly active drug against protozoa and microorganisms. They are treated with giardiasis, amoebic dysentery and trichomoniasis.

The drug should be taken orally, immediately before meals, and washed down with a small amount of water. Children with giardiasis need only a single dose of 30 mg per kilogram of body weight, that is, the treatment lasts only one day, and moreover, the treatment is just one tablet. And that’s it. This is a one time use. Nothing better than this has come up yet. The drug is produced by the English Laboratory Bailey-Kreat, and one pack of 2 tablets will cost from 520 to 790 rubles. Why was the package made into two tablets? Because for adults, the treatment of acute amoebic dysentery just involves a single dose of two tablets.

Advantages and disadvantages

The advantage of this tool is its high activity, which allows it to be used in many cases once. But at the same time, it must be remembered that it can cause urticaria, and moderate and reversible, but still leukopenia, that is, a decrease in leukocytes in the blood plasma, as well as some symptoms from the central nervous system and digestion. These are dizziness, unsteadiness of gait, decreased skin sensitivity, nausea, discomfort in the abdomen and a metallic taste in the mouth.

Contraindications should also be taken into account: hypersensitivity to imidazole derivatives, blood and bone marrow disease, children under 3 years of age or children weighing less than 16 kg. The thing is that Seknidox is available in tablets weighing 1 g, and children under 3 years old simply cannot swallow them, but can inhale or choke. Therefore, Seknidox should be prescribed only for children older than 3, and preferably 4-5 years of age.

Tenonitrosol (Atrican-250)

Rating: 4.7

Finally, the last reserve drug that we will consider in the fight against Giardia is tenonitrozole, or Atrikan. It is sold in two varieties: Atrikan-250, and Atrikan-500. At the moment, for the treatment of giardiasis, the first option is just needed. Then a package of 8 enteric capsules of 250 mg will cost from 260 to 510 rubles. This medicine is produced by the French company Innotech International. The drug is also an imidazole derivative. These capsules are soft, yellow, oval. If the capsule is broken, then inside there will be a homogeneous mass with a slight odor, grayish-brown in color. This medicine is one of the strongest drugs against the treatment of trichomoniasis, but is also active against candidiasis and giardiasis. Please note that this drug should not be given to children under 12 years of age. For children over 12 years old, Atrikan is prescribed at a dosage of 500 mg per day in two doses, that is, one 250 mg capsule in the morning and one in the evening, the course of treatment is 4 days.

Advantages and disadvantages

This is a really strong and powerful reserve drug, but it has a big drawback: it cannot be prescribed to children under 12 years old, and it is difficult to get it in pharmacies, it is available only in pharmacies of large regional and regional centers, as well as capitals. It must be remembered that children should not wear contact lenses during treatment, and it should not be prescribed to persons over 12 years of age if there are severe liver dysfunctions, this is a contraindication.

How to treat? Criteria for cure

But the fact that the drug is chosen is not the end, but only the beginning of the matter. It is necessary to follow diet therapy, children are on the 4th table according to Pevzner, which corresponds to patients with chronic intestinal damage, and if giardiasis occurs with a predominant lesion of the hepatobiliary zone, then the diet should go according to table No. 5. In any case, it is necessary to limit carbohydrates and sugar for the duration of treatment , flour products and muffins, what lamblia love. Children can be difficult to endure separation from sweets, especially girls, so it is advisable to select the drug also taking into account the duration of the course and take into account the nature of the baby.

Easily digestible protein and dietary fiber should be present in food, something that Giardia does not like. The first stage of treatment consists of prescribing the selected drug, observing the rules of hygiene, washing hands after using the toilet. The child’s nails need to be cut short and washed daily with a brush and soap: if after going to the toilet “for the most part” the cysts get under the child’s nails, and after the end of the treatment they end up in his mouth, then everything will “go down the drain”

After the end of taking the drug, sorbents are prescribed for detoxification, for example, children’s “Enteros-gel”. Then eubiotics, for example, Linex, Bifiform, Bifidumbacterin for 2-3 weeks. After the end of treatment, in case of fatty stools, bloating, the presence of symptoms of chronic pancreatitis, pancreatic enzymes are prescribed, for example, Creon, Festal, Enzistal. According to the indications, drugs with a choleretic and hepatoprotective effect should be prescribed if there are symptoms, for example, biliary dyskinesia.

After treatment, the result can be considered achieved if you pass feces for Giardia three times, and they will not be detected, while the interval between the first two analyzes should be two to three days, and the last, third analysis must be taken after 2 weeks. If the result of PCR in feces 3 weeks after treatment for Giardia DNA is negative, and if the determination of Giardia antigens in feces by ELISA after 2 weeks is also negative, then the child is cured. In this case, it is desirable to combine methods, for example, real-time PCR and a triple scatological study.

Prevention

Giardia can be infected and sick with giardiasis many times, no immunity to these parasites is formed in either children or adults. Therefore, all prevention is to avoid infection. It is necessary to carefully teach the child to observe the rules of personal hygiene, and to show this example themselves. It is necessary to wash hands, vegetables and fruits, boil drinking water, fight flies in the summer, preventing them from being on food, on bread, on cutting boards.

It is also forbidden to swim in reservoirs with a dirty, muddy bottom, where beaches are not provided, to swallow river water.

It’s easier than ever to get giardiasis if you don’t get rid of the bad habit of biting your nails. If you have a pet, then it is necessary to “anthelmintic” it in a timely manner, and when carrying out anthelmintic prophylaxis, it is necessary to choose such a drug so that, in addition to the anthelmintic effect, it also destroys protozoa. Those who follow these simple rules and teach them to follow the child do not have to worry about re-infection with giardiasis.

Attention! This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.