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Therapeutic effect of phenyl vinyl sulfone and nitazoxanide on experimentally infected mice with cryptosporidiosis

Objective Evaluation of the therapeutic effect of phenyl vinyl sulfone (PVS) as cysteine protease inhibitors, nitazoxanide (NTZ), and combined therapy on Cryptosporidium parvum infection regarding the parasitological and histopathological parameters. Background Cryptosporidium spp. had been identified as the second most important diarrheal pathogen after rotavirus in young children. The immune status of the host plays a critical role. There is no reliable treatment for cryptosporidiosis, as the only approved drug NTZ provides no benefit for immunocompromised patients. Materials and methods A total of 180 female laboratory-bred Swiss albino mice were divided into two major divisions, immunocompetent and immunosuppressed, with the following groups for each one, respectively: negative control (I and VI), infected control (II and VII), infected treated with PVS (III and VIII), infected treated with NTZ (IV and IX), and infected treated combined (V and X). Stool examination for oocyst shedding was done at different days postinfection, and mice were killed at 18 and 30 days postinfection (groups A and B, respectively). Histopathological assessment of the ileum was done, and the endogenous developmental stages of the parasite were counted. Results Combined therapy in groups V and X resulted in the highest reduction in Cryptosporidium spp. oocysts shedding (P = 0.044 and <0.001, respectively) and mean number of endogenous developmental stages in group X (P < 0.001) than either drugs when used alone. This is followed by NTZ-treated groups and then cysteine protease inhibitors-treated groups, which gave the least reduction. Conclusion Combined therapy is more effective than either NTZ or PVS used alone. NTZ is still a better treatment option than PVS.