THE COMPARISON OF EFFICACY AND SIDE EFFECT BETWEEN ALBENDAZOLE AND METRONIDAZOLE IN THE MANAGEMENT OF GIARDIASIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Indonesia and other developing countries have exposed to multiple types of neglected parasitic infections, including giardiasis. The reliability of metronidazole as first-line drugs is doubted for its side effects and compliance; albendazole could appear as another alternative. We established evidence of the efficacy and side effects between Metronidazole and Albendazole through systematic review and meta-analysis study. We performed online search followed by peer-reviewed literature in Pubmed, Cochrane, Clinical Key, Science Direct, and Google Scholar published before January 2018. Statistical analysis of size effects calculation was conducted using Review Manager 5.3 to provide an estimation of odds ratios (ORs) with 95% confidence interval (CIs). A total of 715 patients were enrolled in the pooled size analysis from six studies, which is suitable for further calculation. The efficacy of infection resolutions and adverse effects (abdominal pain, vomiting, anorexia, metallic taste, and dizziness) were contested against each other. Study analysis revealed that there were not any significant differences in the efficacy (OR 1.11 95% CI 0.66-1.87, p=0.22), as well as abdominal pain (p=0.14) and vomiting (p=0.22) between two agents. Nevertheless, metronidazole treated patients were more prone to anorexia (p<0.00), metallic taste (p<0.00), and dizziness (p=0.01) compared to Albendazole group. The meta-analysis results indicated that metronidazole was not superior to albendazole for giardiasis; however, there were fewer side effects that occurred among the albendazole treated patients. Therefore, it was suggested that the administration of albendazole should be considered among giardiasis patients in any situation.