Role of nitazoxanide as a repurposed drug in the treatment and management of various diseases

Nitazoxanide (NTZ) is an orally active drug with significant postmarketing experience including more than 75 million adults and children. Presently, this drug is widely used for a number of infectious conditions and diseases. It has a wide range of applications such as antiprotozoal, anthelmintic and antiviral against various types of Gram-positive and Gram-negative bacteria, parasites and certain viruses. Chemically, NTZ nitrothiazole is a [2-[(5-nitro-1,3-thiazol-2-yl) carbamoyl]phenyl] acetate compound. A number of clinical trials have suggested that it can be used in cryptosporidiosis, hepatitis B, hepatitis C, ovarian cancer, viral infections and helicobacter infection. Recent research has proposed its beneficial effect in treating the symptoms of coronavirus infection. It is proposed that the activity of NTZ is due to interference with pyruvate-ferredoxin oxidoreductase (PFOR), which is an enzyme that catalyzes the ferredoxin-dependent electron transfer reaction completed in anaerobiotic energy metabolism. The available literature suggested the importance of NTZ and its efficiency against various bacterial infections as well as in viral infectious diseases. The aim of this review is to examine and discuss the most important aspects of NTZ in different types of microbial infections.