Unfortunately, these is no universally effective treatment for crypto. Many drugs have been studied in clinical trials. Some have been complete failures. Others have been shown to be effective for some but not for others.
One of the best treatments for crypto appears to be antiretroviral drugs used to treat HIV. By treating HIV effectively, it's possible to increase T-cell counts to levels above 100. In many cases, this has proven to work well for many HIV-positive people with crypto. Unfortunately, crypto can cause malabsorption and may decrease the level of HIV drugs that reach the bloodstream.
There are actually three different approaches that can be taken when treating crypto: to treat the infection, slow the diarrhea, and correct the weight loss.
To treat the infection, some antibiotics have been shown to be somewhat effective. One antibiotic, nitazoxanide (Alinia®), is approved for children with diarrhea caused by a variety of organisms. While it is not yet approved for adults, it is available through pharmacies in the United States.
Another antibiotic sometimes used to treat crypto is azithromycin (Zithromax®). Taken at a dose of 800 mg a day – much higher than the doses used to treat other infections – azithromycin appears to reduce diarrhea and sometimes treat the infection. Even higher doses of the drug are currently being studied in intravenous (IV) form.
A third antibiotic, paromomycin (Humatin®), at a doses between 1500 mg and 2000 mg a day, have been shown to both cure the infection or greatly reduce diarrhea associated with the infection. Like nitazoxanide and azithromycin, paromomycin is approved for sale in the United States, albeit not for crypto. In other words, a doctor can still prescribe it, but cryptosporidiosis will not be listed in the package insert.
Dapsone, a drug sometimes used to treat and prevent Pneumocystis pneumonia (PCP), has also been shown to be somewhat helpful at doses of 750 mg a day.
To help control the diarrhea, perhaps in combination with antibiotic therapy, a number of anti-diarrheal drugs can be taken. These include: octreotide (Sandostatin®), Lomotil®, loperamide (Imodium®), paregoric, and Pepto-Bismol®. And because diarrhea is the direct result of intestinal inflammation caused by the infection, some non-steroidal anti-inflammatory drugs (NSAIDS) may be helpful such as ibuprofen (e.g., Advil®).
In the event of weight loss, it might be necessary to treat people with crypto using nutritional supplementation. Unfortunately, many nutritional supplements that can be taken by mouth aren't absorbed properly, thus requiring nutritional supplementation through an intravenous (IV) line. This is called total parenteral nutrition (TPN) and, despite its high cost, it can be very effective in providing the body with the nutrients it needs.
Some anabolic agents, such as human growth hormone (Serostim®) and anabolic steroids (e.g., Deca-Durabolin®, Oxandrin®, Winstrol®), can be useful in preventing – and perhaps reversing – muscle loss that often occurs in people with weight-reducing infections like crypto.
The most effective way to prevent crypto is to avoid its sources – mainly
contaminated drinking water. HIV-positive people with severely compromised
immune systems are often encouraged to drink bottled or boiled water.
It's also best to peel fruits and vegetables and/or wash them thoroughly
in boiled water.
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