A person treated for giardiasis may fail to respond for a number of reasons. It is necessary to find the cause in order to plan an effective management plan.
Reaons for failure to respond to therapy with persistent giardia in stool:
(1) inappropriate drug selected
(2) inadequate dose of drug prescribed or duration of therapy
(3) protozoa resistant to the selected drug
(4) nonadherence by the patient
(5) reinfection
(6) immunosuppression
(7) colonization of gallbladder or pancreatic duct (sequestration, where the protozoa can evade the medication)
Reasons for persistent symptoms with absence of giardia in stool
(1) clinical symptoms due to a cause other than Giardia
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