Randomized double-blind trial of metronidazole versus secnidazole in amebic liver abscess.
OBJECTIVE
To compare the efficacy of secnidazole with metronidazole in the treatment of amebic liver abscess.


METHODS
Thirty two patients with uncomplicated liver abscesses were studied in a randomized, double-blind trial. Fifteen received metronidazole (400 mg t.i.d. for 7 days) and 17 secnidazole (500 mg t.i.d. for 5 days). All abscesses were aspirated on day 1 and laboratory tests and ultrasonographic examination were done on days 1 and 10.


RESULTS
One patient in the metronidazole group developed intraperitoneal rupture. The other 31 patients had 40 abscesses (19 in metronidazole group, 21 in secnidazole group). Complete resolution of signs occurred by day 10 in 10 patients on metronidazole and 12 on secnidazole, and in all others by day 28. On day 10 ultrasonography in the metronidazole group showed complete disappearance of abscess in one patient, decrease in 8 and increase in 5 (versus 2, 12 and 3, respectively in the secnidazole group). After 6 months, four asymptomatic patients (two from each group) had small abscess cavities on ultrasonography; there were no recurrences.


CONCLUSIONS
Secnidazole is as effective in the treatment of amebic liver abscess as metronidazole; it is equally well tolerated.
Bhatia
S
S
Department of Medicine, King Edward Memorial Hospital, Mumbai.
Karnad
D R
DR
Oak
J L
JL
D000328:Adult; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008101:Liver Abscess, Amebic / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008795:Metronidazole / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D014463:Ultrasonography
D000981:Antiprotozoal Agents; D008795:Metronidazole; C016724:secnidazole