SynthesisInfectious diseases and therapy2026
Treatment for Dientamoeba fragilis: A Systematic Review and Meta-analysis.
Synthesis in Infectious diseases and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
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Abstract
introductionDientamoeba fragilis (D. fragilis) is detected in stool tests of patients with gastrointestinal symptoms. Despite a debate over its pathogenicity, treatment is often prescribed, after excluding other reasons. The most commonly used therapy in practice is metronidazole; however, evidence to support this practice is limited.
methodsWe conducted a systematic review and meta-analysis compiling studies evaluating metronidazole vs any other regimen for the treatment of D. fragilis. Studies reporting treatment outcomes (clinical and/or microbiological) of D. fragilis regimens diagnosed by standard stool microscopy and polymerase chain reaction. We searched PubMed, Cochrane library, and Web of Science up to March 2025 for relevant studies. The primary outcome was clinical response; microbiological response was a secondary outcome.
resultsWe included 12 comparative studies in the quantitative meta-analysis and additional non-comparative studies in the qualitative systematic review. Two studies were randomized controlled trials (RCT), and others were observational studies. Nine studies were included in the analysis of the primary outcome. Significantly higher clinical response rates were demonstrated with paromomycin (odds ratio [OR] 2.31, 95% confidence interval [CI] 1.37-3.89, without heterogeneity) and clioquinol (odds ratio [OR] 2.52, 95% confidence interval [CI] 1.26-5.05, without heterogeneity) compared to metronidazole therapy. Significantly higher microbiological response was demonstrated with paromomycin (OR 3.94, 95% CI 2.75-5.65) and a trend for higher response for clioquinol (OR 1.41, 95% CI 0.68-2.92), compared with metronidazole.
conclusionsLimited data compiled in this meta-analysis supports the use of paromomycin or clioquinol for treatment of D. fragilis symptomatic infection, in case a decision to treat this pathogen is taken. Future studies correlating clinical efficacy with microbiological eradication are needed.
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