{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:22:43Z","timestamp":1791354163033,"version":"4.3.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Limited evidence exists on efficacy and tolerability of quinacrine for nitroimidazole-refractory giardiasis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Nitroimidazole-refractory giardiasis cases, defined as microbiologically (microscopy and\/or PCR) confirmed treatment failure after 2 courses, during 2008\u20132020, were retrospectively identified.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 87 patients, 54 (62%) had visited India. Quinacrine was used in 54 (62%); 51 received monotherapy and 3 combined with metronidazole. Only 3 had positive stool samples with persisting symptoms after quinacrine treatment (94% parasitological efficacy) and all were cured after a second treatment. One (1.9%) had mild adverse effects recorded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Quinacrine is an effective treatment for nitroimidazole-refractory giardiasis with good tolerability.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiab287","type":"journal-article","created":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T19:12:05Z","timestamp":1621624325000},"page":"1773-1776","source":"Crossref","is-referenced-by-count":10,"title":["Quinacrine Treatment of Nitroimidazole-Refractory Giardiasis"],"prefix":"10.1093","volume":"225","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3115-3099","authenticated-orcid":false,"given":"Karin A","family":"Ydsten","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urban","family":"Hellgren","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilmir","family":"Asgeirsson","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Unit of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"key":"2022051716044027500_CIT0001","doi-asserted-by":"crossref","first-page":"i5369","DOI":"10.1136\/bmj.i5369","article-title":"Giardiasis","volume":"355","author":"Minetti","year":"2016","journal-title":"BMJ"},{"key":"2022051716044027500_CIT0002","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1517\/14656566.8.12.1885","article-title":"Giardiasis: a pharmacotherapy review","volume":"8","author":"Escobedo","year":"2007","journal-title":"Expert Opin Pharmacother"},{"key":"2022051716044027500_CIT0003","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/QCO.0000000000000668","article-title":"Giardiasis treatment: an update with a focus on refractory disease","volume":"33","author":"M\u00f8rch","year":"2020","journal-title":"Curr Opin Infect Dis"},{"key":"2022051716044027500_CIT0004","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.cmi.2015.04.019","article-title":"Increased incidence of nitroimidazole-refractory giardiasis at the hospital for tropical diseases, London: 2008\u20132013","volume":"21","author":"Nabarro","year":"2015","journal-title":"Clin Microbiol Infect"},{"key":"2022051716044027500_CIT0005","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1093\/infdis\/jix066","article-title":"The use of quinacrine in nitroimidazole-resistant Giardia duodenalis: an old drug for an emerging problem","volume":"215","author":"Requena-M\u00e9ndez","year":"2017","journal-title":"J Infect Dis"},{"key":"2022051716044027500_CIT0006","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.tmaid.2012.10.004","article-title":"Refractory giardiasis in Spanish travellers","volume":"11","author":"Mu\u00f1oz Guti\u00e9rrez","year":"2013","journal-title":"Travel Med Infect Dis"},{"key":"2022051716044027500_CIT0007","doi-asserted-by":"crossref","first-page":"1092.e1","DOI":"10.1016\/j.cmi.2019.12.017","article-title":"5-Nitroimidazole refractory giardiasis is common in Matanzas, Cuba and effectively treated by secnidazole plus high-dose mebendazole or quinacrine: a prospective observational cohort study","volume":"26","author":"Canete","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"2022051716044027500_CIT0008","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1001\/archderm.1980.01640290097026","article-title":"Antimalarial agents. 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