⚕️ Efficient Protocol for Waterborne Parasites (Thailand & Vietnam)

This revision is from 2025/10/14 04:45. You can Restore it.

Day Drug Dose Time(s) to take Target Notes
Day 1 Albendazole 400 mg — single dose 20:00 (evening) — take with a fatty meal Common intestinal helminths (Ascaris, hookworm, Trichuris) Baseline deworming; avoid if pregnant. Taking with food enhances absorption.
Days 2–4 Nitazoxanide 500 mg — twice daily (total 6 doses) 08:00 & 20:00 each day (with food) Giardia, Cryptosporidium, Blastocystis, some Entamoeba Preferred broad protozoal course; well tolerated. Do not combine with tinidazole simultaneously.
Days 5–6 Rest / Supportive care — Hydration throughout the day; probiotics morning & evening Recovery / assess response Light diet, bottled/boiled water, ORS if loose stools; consider S. boulardii or equivalent probiotic.
Day 7 (optional) Tinidazole (only if persistent symptoms) 2 g — single dose 08:00 (single dose, with food) Amoebiasis or tinidazole-responsive Giardia Use only if no improvement after nitazoxanide; avoid alcohol during and 72 h after dose; not for pregnancy.

⚕️ Efficient Protocol for Undercooked Meat or Fish Exposure (Thailand & Vietnam)

Day Drug Dose Time(s) Target Parasites Notes
Day 1 Albendazole 400 mg — single dose (with fatty meal) 20:00 General intestinal worms (*Taenia*, *Ascaris*, *Trichuris*) Basic deworming foundation. Enhances safety of later praziquantel dose.
Days 2–3 Praziquantel 25 mg/kg per dose, three doses per day (total 75 mg/kg/day) × 2 days 08:00, 14:00, 20:00 (with meals) Tapeworms, liver flukes, lung flukes Do not combine with alcohol. May cause dizziness or nausea. Liver support (hydration, rest).
Days 4–5 Rest / Recovery — Hydrate and monitor symptoms morning & night Liver and GI recovery Bland diet, probiotics, no alcohol, avoid heavy fats. Re-evaluate energy, digestion, and stool.
Day 7 Ivermectin (optional) 200 µg/kg single dose 08:00 (before breakfast) Strongyloides, other nematodes Take on empty stomach; avoid if unconfirmed filarial infection.

🌏 Unified Broad-Spectrum Parasite Treatment Protocol (Thailand & Vietnam)

Covers: Tapeworms, flukes, roundworms, Giardia, amoebae, Cryptosporidium, Strongyloides, Trichinella, and most protozoa.

Day Drug Dose Time(s) Targets Notes
Day 1 Albendazole 400 mg single dose (evening) 20:00 — with fatty meal Roundworms, hookworm, Taenia cyst stage Foundation dewormer. Precedes praziquantel to reduce cyst activation risk.
Days 2–3 Nitazoxanide 500 mg twice daily × 3 days 08:00 & 20:00 — with food Giardia, Cryptosporidium, amoebae, Blastocystis Gentle and effective for protozoa; may turn urine yellow-green temporarily.
Days 4–5 Praziquantel 25 mg/kg per dose × 3 doses per day (every 6 hours) 08:00 / 14:00 / 20:00 — with meals Tapeworms, flukes, schistosomes Take with meals. May cause dizziness or nausea. Hydrate well.
Day 7 Ivermectin (optional) 200 µg/kg single dose 08:00 — empty stomach Strongyloides, cutaneous nematodes Only if skin rash or soil contact likely. Avoid alcohol for 24 h before/after.

🇮🇳 India Specific

Day Drug Dose Time(s) to take Primary targets Notes / next steps
Day 1 (start) Albendazole 400 mg PO — single dose 20:00 — with a fatty meal STH: *Ascaris*, hookworm, *Trichuris*; partial coverage for tissue worms Baseline deworming to reduce worm load and aid recovery. Avoid in pregnancy.
Days 1–3 (start immediately) Nitazoxanide 500 mg PO twice daily × 3 days 08:00 & 20:00 — with food Protozoa: *Giardia*, *Cryptosporidium*, *Blastocystis*; some *Entamoeba* Good first-line for suspected metronidazole-resistant *Giardia/Entamoeba*. Monitor tolerance; urine may darken slightly.
Day 4 Rest / assess — Hydration, light diet, probiotics AM/PM Recovery & response check If symptoms improved → stop and monitor. If persistent/worse → follow refractory steps below (Day 5+).
Day 5 (refractory option) Tinidazole (or Metronidazole alternative) Tinidazole 2 g PO once — OR Metronidazole 500 mg PO TID × 7 days 08:00 (single tinidazole dose with food) — avoid alcohol 72 h Refractory *Giardia* or *Entamoeba* (amoebic colitis needs clinician confirmation) If *E. histolytica* suspected clinically, follow tinidazole/metronidazole with a luminal agent (e.g., paromomycin or diloxanide) per clinician.
Day 6–7 (optional) Ivermectin (only if indicated) 200 µg/kg PO once (may repeat next day if local guidance) 08:00 — empty stomach *Strongyloides* (suspected with eosinophilia, pruritic rash, pulmonary symptoms) Only use when clinical/epidemiologic suspicion; check for filarial co-endemic risk if relevant. Not for pregnancy.
Supportive (Days 1–14) Hydration, probiotics, nutrition Probiotic (e.g., S. boulardii 250 mg) AM & PM; ORS PRN Morning & evening Gut recovery, prevent dehydration Avoid raw/uncertain food & ice; follow up if weight loss continues.

  

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