Therapy of entamebiasis.
Therapy of entamebiasis is critical in that, if untreated, the disease can be fatal. Recently, a new method for differentiating pathogenic and non-pathogenic amebae has been standardized. This method relies upon the electrophoretic analysis of 4 isoenzymes which allow the identification of 20 different zymodemes. It is now widely accepted that non-pathogenic strains of Entamoeba histolytica are not a hazard for humans and therefore don't need therapy. As a consequence, treatment must be addressed only toward infections caused by pathogenic strains. As there are different drugs available for treating amebiasis, from a therapeutical point of view the disease must be divided into two forms: intestinal and extraintestinal. For the former, drugs which reach therapeutical levels in the gut are required. The mainstay for the treatment of asymptomatic carriage of pathogenic strains is DILOXANIDE FUROATE, a very well tolerated luminal amebicide. METRONIDAZOLE and other 5-nitroimidazole compounds such as ORNIDAZOLE are indicated for the treatment of symptomatic intestinal infections as they reach good concentrations in tissues, including the bowel where ulcerations develop. In order to ensure the clearance of amebae from the gut, a subsequent cycle with diloxanide furoate is advisable. Extraintestinal forms include amebic abscesses which can develop in many sites, but most commonly in the liver. Metronidazole and related compounds are the drugs of choice; in case of liver abscess, the addition of CHLOROQUINE is indicated because of its good concentration in tissues. A subsequent cycle with diloxanide furoate is also indicated.(ABSTRACT TRUNCATED AT 250 WORDS)
Di Perri
G
G
Department of Infectious Diseases, University of Pavia, IRCCS Policlinico, San Matteo, Italy.
Strosselli
M
M
Rondanelli
E G
EG
D000562:Amebiasis / Q000188:drug therapy*; D000563:Amebicides / Q000627:therapeutic use*; D000818:Animals; D002738:Chloroquine / Q000627:therapeutic use; D004748:Entamoeba histolytica / Q000145:classification; D004749:Entamoebiasis / Q000188:drug therapy* / Q000453:epidemiology; D005663:Furans / Q000627:therapeutic use; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D009950:Ornidazole / Q000627:therapeutic use; D012307:Risk Factors
D000563:Amebicides; D005663:Furans; D008795:Metronidazole; D009950:Ornidazole; D002738:Chloroquine; C004932:diloxanide furoate