If symptoms of giardiasis are minimal, therapy can be withheld until after delivery
. If symptoms are bothersome, paromomycin (25 to 35 mg/kg per day PO in three divided doses for seven days) can be used. Paromomycin, a nonabsorbable aminoglycoside, eliminates cysts in only 60 to 70 percent of patients, but it may provide symptomatic relief. If giardiasis in pregnancy is associated with dehydration, malabsorption, or severe symptoms, therapy with metronidazole is warranted.