From the Guidelines
The treatment for amoebiasis typically involves the use of antimicrobial agents, such as metronidazole (500 mg orally, three times a day for 7-10 days) or tinidazole (2 g daily for 3 days) 1.
Key Considerations
- Metronidazole results in a cure of over 90% of cases 1
- Tinidazole is an alternative and will result in less nausea 1
- Most patients will respond within 72-96 hours 1
Additional Treatment
- Once treatment with tinidazole or metronidazole is complete, all patients should receive a luminal amoebicide, such as diloxanide furoate (500 mg orally, three times a day) or paromomycin (30 mg/kg per day orally in 3 divided doses) for 10 days to reduce the risk of relapse 1
- Paromomycin may be used in cases of asymptomatic carriers or mild intestinal infection 1
Severe Infections
- For severe intestinal or extraintestinal infections, a combination of metronidazole and a luminal agent such as paromomycin or iodoquinol may be employed 1
- Tinidazole or metronidazole are effective in the treatment of amoebic dysentery 1
From the FDA Drug Label
1.3 Amebiasis Tinidazole is indicated for the treatment of intestinal amebiasis and amebic liver abscess caused by Entamoeba histolytica in both adults and pediatric patients older than three years of age. Amebiasis Metronidazole tablets are indicated in the treatment of acute intestinal amebiasis (amebic dysentery) and amebic liver abscess. Paromomycin sulfate is indicated for intestinal amebiasis–acute and chronic (NOTE-It is not effective in extraintestinal amebiasis);
The treatment for amoebiasis includes:
- Tinidazole 2 for intestinal amebiasis and amebic liver abscess
- Metronidazole 3 for acute intestinal amebiasis and amebic liver abscess
- Paromomycin 4 for intestinal amebiasis (not effective in extraintestinal amebiasis)
From the Research
Treatment Options for Amoebiasis
- Tinidazole is a synthetic imidazole derivative that has been used in the oral treatment of amoebiasis, with a single 2g dose showing effectiveness in intestinal amoebiasis 5.
- Metronidazole is also widely used to treat protozoan infections, including amoebiasis, with a cure rate of 88% in one study 6.
- Ornidazole has been shown to be effective in treating amoebiasis, with a cure rate of 94% in one study 6.
- Probiotics, such as Lactobacillus casei and Enterococcus faecium, have been investigated as a potential preventive treatment for amoebiasis, with promising results 7.
- Other treatments, such as albendazole and mebendazole, have been compared to metronidazole in the treatment of giardiasis, but the evidence is limited and of low quality 8.
Comparison of Treatment Options
- Tinidazole has been shown to be equivalent and often superior to metronidazole in the treatment of amoebiasis 5.
- Ornidazole has been shown to be more effective than metronidazole in one study, but the evidence is limited 6.
- Albendazole may be of similar effectiveness to metronidazole in the treatment of giardiasis, but the evidence is limited and of moderate quality 8.