Table 1. Activity of Antiparasitic Drugs Against E. Histolytica Strain 200 in Axenic Culture
|
Drug |
ED50 (mg base/l) |
(mg base/l) |
|
Lumenal agents |
|
|
|
Iodohydroxyquinoline sulfonic acid |
33 |
(30-35) |
|
Diloxanide |
0.88 |
(0.83-0.94) |
|
Paromomycin |
0.73 |
(0.69-0.76) |
|
Tissue amebicides |
|
|
|
Metronidazole |
0.010 |
(.0093-0.011) |
|
Tinidazole |
0.032 |
(0.029-0.036) |
|
Ornidazole |
0.032 |
(0.029-0.035) |
|
Chloroquine sulfate |
85 |
(75-96) |
|
Emetine |
0.09 |
(0.07-0.099) |
|
Dehydroemetine |
0.25 |
(0.22-0.29) |
Adapted from (40)
Table 2. Antimicrobial Therapy for E. Histolytica Infection [Download PDF]
|
Scenario |
Drugs of choice Adult dose (pediatric dose) |
Comments |
Second-line drugs Adult dose (pediatric dose) |
|
Asymptomatic intestinal colonization |
Paromomycin 25-35 mg/kg/d po ¸ tid x 7-10d |
|
Diloxanide 500mg po tid (20mg/kg/d ¸ tid) x 10d
Iodoquinol 650mg po tid (30-40 mg/kg/d ¸ tid) x 20d |
|
Amebic colitis |
Metronidazole 750mg po tid (35-50mg/kg/d ¸ tid) x 5-10 d or Tinidazole 2g po qd (50mg/kg qd) x 3-5d |
Follow with course for asymptomatic colonization |
|
|
Amebic liver abscess |
Metronidazole 750mg po tid (35-50mg/kg/d ¸ tid) x 10 d or Tinidazole 2g po qd (50mg/kg qd) x 5d |
If not responding within 72h consider drainage
Follow with course for asymptomatic colonization |
Dehydroemetine or chloroquine |
Figure 1. Motile E. histolytica Trophozoite in Stool Sample Showing Ingested Red Blood Cells.
Image courtesy of the Herman Zaiman collection.
Figure 2. Colonoscopy of a Patient with Amebic Colitis who Presented with Right
Lower Quadrant Pain and Bloody Diarrhea
Figure 3. Computed Tomography of a Patient with Amebic Liver Abscess who
Presented with Fever, Right Upper Quadrant Pain and Pleuritic Pain
