Paromomycin
Mechanism :
Acts directly on amoeba; interferes with bacterial protein synthesis by binding to 30S ribosomal subunits.
Indication :
- Intestinal amoebiasis
- Adjunctive management of hepatic coma
- Off-label:
- Cryptosporidiosis-associated diarrhea in HIV-infected
- Dientamoeba fragilis infection
Contraindications :
Hypersensitivity to paromomycin or any component of the formulation; intestinal obstruction.
Dosing :
Oral
25 to 35 mg/kg/day in 3 divided doses.
Duration: 5 to 10 days for intestinal amoebiasis, 14-21 days for cryptosporidiosis-associated diarrhea in HIV-infected patients. 7 days for Dientamoeba fragilis.
Adverse Effect :
Abdominal cramps, diarrhea, heartburn, nausea, vomiting, Enterocolitis (secondary), eosinophilia, headache.
Interaction :
No known significant interactions.
Hepatic Dose :
No oral dosage adjustment required. Use aminoglycosides with caution in patients with severe hepatic disease, as it may precipitate hepatorenal syndrome.