⚕️ Efficient Protocol for Waterborne Parasites (Thailand & Vietnam)

This revision is from 2025/10/14 04:50. You can Restore it.

Only proceed to the next drug if the previous drug did not clear up condition, which means test and see rest days in between. For most people single dose Albendazole is all that is required.

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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