Treatment is not always necessary. Giardia can self-resolve.
You want to prevent and treat dehydration.
Remember, infants, pregnant women, and the elderly population
are at the highest risk for dehydration complications.
There are prescription medications available including metronidazole.
That's first-line therapy. It can be given in pregnancy after the first trimester.
Another treatment for giardia is albendazole but this is not safe in pregnancy.
So we need to manage pediatric hydration.
Kids don't drink enough fluids usually when they're having diarrhea to maintain their fluid stores.
So they wanna keep their urine clean or pale yellow.
You can have the parents watch for this.
You want parents to avoid giving their children foods or drinks high in sugar
because the sugar is gonna pull more water into the bowel contributing to more diarrhea.
You want to avoid carbonated drinks and juice for the same sugary reason.
Children should avoid caffeinated drinks and avoid fatty, greasy foods.
When you're managing a pediatric patient with giardia,
the clinician needs to determine if the patient is dehydrated.
Most parents assume that every child with diarrhea needs IV fluids
but we know that we can replace fluids orally most of the time.
So you need to decide how dehydrated your patient is.
And first, if they're not dehydrated, they're just gonna start replacing their fluids
with oral rehydration solution and this is a mixture of electrolytes and water.
And the child's gonna have an age-appropriate diet.
Next, if you determine the child has mild dehydration,
you're going to give them more of the oral rehydration solution
and a maintenance amount of oral rehydration solution.
After they're hydrated, they can resume their age-appropriate diet.
Next, children with moderate dehydration
are gonna need a larger quantity of the oral rehydration solution and a baseline intake.
Then, they can eat and drink normally. Now, this is the worrisome population.
This is the severe dehydration group and these children will likely need IV fluid resuscitation
with boluses and then once they're hydrated,
they can begin oral rehydration and they're gonna need to maintain their intake.
And if they can't, they will need more IV fluids.
Giardia has some complications including weight loss, dehydration, lactose intolerance
because of its enzyme disruption, and children less than 5 years old
are at risk for malnutrition and this can interfere with physical and mental development.