Treatment of Entamoeba histolytica Infection

Advice on the treatment of symptomatic and asymptomatic E. histolytica infection is beyond the scope of this site and in any case should be provided by the individual's personal physician. However, for those interested in clinical diagnosis and treatment, information can be found in the following three publications:

Pillai, D.R., Keystone, J.S. & Kain, K.C. (2000) Treatment. In J. I. Ravdin (ed.), Amebiasis. London: Imperial College Press, pp. 127-136.

Ravdin, J.I. (1995) Amebiasis (Review). Clin. Infect. Dis. 20: 1453-1466.

Reed, S.L. (1992) Amebiasis: an update. Clin. Infect. Dis. 14: 385-393.

Based on these and other recent publications the usual drug regimens recommended are:

Presentation:
Drug:
Adult Dosage:
Efficacy:
Asymptomatic cyst passage -
(luminal infection only)
Diloxanide furoate
500 mg t.i.d., 10 days
87-96%
Iodoquinol
(Diiodohydroxyquin)
650 mg t.i.d., 20 days
95%
Paromomycin
500 mg t.i.d, 10 days
OR 30 mg/kg/day in 3 doses, 5-10 days
85-90%
Invasive Rectocolitis -
(Note)
Metronidazole
750 mg t.i.d., 5-10 days
OR 50 mg/kg, 1 dose
90+%
86%
Tinidazole
50 mg/kg q.d., 3 days
Amoebic Liver Abscess -
(Note)
Metronidazole
750 mg t.i.d., 5-10 days
OR 2.4 g q.d., 1-2 days
95%
Tinidazole
2 g p.o.
Ornidazole
2 g p.o.

Note: Treatment of invasive amoebiasis should ALWAYS be followed up with treatment for lumenal parasites as these are not eliminated by the drug regimen for invasive disease in many cases.

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