Giardiasis is associated with malabsorption and diarrhea. Both factors can result in poor absorption of oral medications.
Presentation: A patient on oral medications fails to respond as expected to an oral medication.
Findings:
(1) Serum levels of the drug are less than expected for the dose given.
(2) The patient is diagnosed with giardiasis.
(3) Serum levels after treatment of the giardiasis increase to predicted levels.
(4) The patient clinically responds to the oral medication after treatment for giardiasis.
Problems in diagnosis:
(1) The patient is not evaluated for giardiasis.
(2) The lack of response to therapy is misdiagnosed as noncompliance or resistance to therapy.
It may be necessary to deliver essential medications by the parenteral route until the giardia has been treated.
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Specialty: Infectious Diseases, Gastroenterology
