How do I treat Entamoeba histolytica?


According to the National Institutes of Health StatPearls, here are treatment options for Entamoeba histolytica.

"Metronidazole is the first-line treatment for intestinal amebiasis and amebic liver abscess followed by a luminal agent. Typical dosing for metronidazole is 500 to 750 mg orally 3 times a day for 7 to 10 days in adults. Metronidazole can be safely used in children at a dosing of 35 mg/kg to 50 mg/kg per day divided into three doses. Luminal agents include the following: paromomycin, diiodohydroxyquin, or diloxanide furoate. Dosing for paromomycin is 25 mg/kg to 30 mg/kg per day divided into three doses for 7 days, diiodohydroxyquin is 650 mg orally for 20 days, diloxanide furoate is 500 mg orally three times a day for 10 days.

Alternatives to metronidazole include tinidazole, ornidazole, and nitazoaxanide

In patients with fulminant amoebic colitis or signs of peritonitis, broad-spectrum antibiotics should be started. Surgical intervention may be required with bowel perforation or toxic megacolon.   

In uncomplicated cases of amebic liver abscess, it has been shown that there is no benefit to drainage in addition to medical therapy. In situations where there is a lack of clinical response to antibiotic therapy, aspiration or catheter drainage may be necessary.

Pleuropulmonary infections should be treated by aspiration of amebic pleural effusion followed by antimicrobial therapy such as metronidazole with a luminal agent."


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