Amoebiasis

Simon Drysdale
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Amoebiasis Treatment
All E. histolytica infections (including asymptomatic infections) should be treated. Treatment aims to eliminate mucosa-invading trophozoites and amoeba in the intestinal lumen. E. dispar infections do not usually require treatment and E. moshkovskii infections may be treated although the benefit of this is uncertain.
Asymptomatic (intraluminal) infections with E. histolytica should be treated with a luminal agent only.

Luminal agents include:
• Paromomycin (25-35mg/kg/d in 3 divided doses orally for 7 days)
• Diloxanide furoate (20mg/kg/d in 3 divided doses orally for 10 days)
• Iodoquinol (30-40mg/kg/d [max 2g/day] in 3 divided doses orally for 20 days)
Individuals with gastrointestinal symptoms or extra-intestinal manifestations should be treated with metronidazole (35-50mg/kg/d in 3 divided doses orally for 7-10 days) or tinidazole (if =3y, 50mg/kg/d [max 2g] once daily orally for 3-5 days) followed by a luminal agent.

Corticosteroids and antimotility agents should be avoided as they worsen disease.

Surgical treatment may be required for severe disease or amoebic abscesses.

Prevention is focused around avoiding contaminated food and water and excellent hand hygiene. Although amoebic cysts are resistant to chlorine, disinfection of water with iodine or boiling the water is usually effective. There is currently no vaccine available.


References
Amoebiasis Amoebiasis 02/13/2016
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