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Penicillin
1%
7/475
Azithromycin
4%
17/475
Metronidazole
79%
374/475
Trimethoprim-sulfamethoxazole
11%
50/475
Ribavirin
2%
8/475
Select Answer to see Preferred Response
This patient presents with giardiasis, which is best treated with metronidazole. Giardiasis is an infectious disease caused by the protozoa Giardia lamblia. The organism attaches to the lining of the walls of the duodenum, and leads to malabsorption and diarrhea. The diarrhea is characteristically foul-smelling and fatty, and patients typically complain of bloating and flatulence. The infection is frequently seen in hikers and campers who consume water from natural sources such as fresh water rivers. Figure A is a stool iodine study showing giardial cysts, which aids in diagnosis of the infection. Incorrect Answers: Answers 1-2, 4-5: none of these antimicrobial agents have activity against giardia.
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