From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The treatment approach for a patient with co-infection of Clostridioides difficile and intestinal amoebiasis requires addressing both pathogens simultaneously, with oral vancomycin 125 mg four times daily for 10-14 days as the first-line therapy for C. difficile, and metronidazole 500-750 mg three times daily for 7-10 days for intestinal amoebiasis, followed by a luminal agent such as paromomycin. The most recent and highest quality study 1 suggests that vancomycin is a superior treatment option for C. difficile, especially in severe cases. For C. difficile, oral vancomycin is recommended as first-line therapy, with oral fidaxomicin as an alternative.
- Key considerations for treatment include:
- Disease severity
- Risk of relapse
- Potential for antibiotic resistance
- For intestinal amoebiasis, metronidazole is administered, followed by a luminal agent such as paromomycin to eliminate cysts.
- Supportive care, including fluid and electrolyte replacement, is essential, and isolation precautions should be implemented to prevent transmission.
- The treatment sequence matters, with concurrent treatment of both infections recommended to prevent worsening of either condition, as supported by studies 2, 3, 4.
- A dual approach is necessary because C. difficile disrupts the gut microbiome while amoebiasis causes tissue invasion, creating a synergistic pathology that requires comprehensive management, as discussed in 5.