Amoebiasis medical therapy

Treatment
E. histolytica infections occur in both the intestine and (in people with symptoms) in tissue of the intestine and/or liver. As a result two different sorts of drugs are needed to rid the body of the infection, one for each location. Metronidazole, or a related drug such a tinidazole, is used to destroy amebae that have invaded tissue. It is rapidly absorbed into the bloodstream and transported to the site of infection. Because it is rapidly absorbed there is almost none remaining in the intestine. Since most of the amebae remain in the intestine when tissue invasion occurs, it is important to get rid of those also or the patient will be at risk of developing another case of invasive disease. Several drugs are available for treating intestinal infections, the most effective of which has been shown to be Paromomycin (also known as Humatin); diloxanide furoate is used in the US. Both types of drug must be used to treat infections, with metronidazole usually being given first, followed by paromomycin or diloxanide. E. dispar does not require treatment, but many laboratories (even in the developed world) do not have the facilities to distinguish this from E. histolytica.

For amebic dysentery a multi-prong approach must be used, starting with one of:


 * Metronidazole 500-750mg three times a day for 5-10 days
 * Tinidazole 2g once a day for 3 days is an alternative to metronidazole

In addition to the above, one of the following luminal amebicides should be prescribed as an adjunctive treatment, either concurrently or sequentially, to destroy E. histolytica in the colon:


 * Paromomycin 500mg three times a day for 10 days
 * Diloxanide furoate 500mg three times a day for 10 days
 * Iodoquinol 650mg three times a day for 20 days

For amebic liver abscess:
 * Metronidazole 400mg three times a day for 10 days
 * Tinidazole 2g once a day for 6 days is an alternative to metronidazole
 * Diloxanide furoate 500mg three times a day for 10 days must always be given afterwards

Doses for children are calculated by body weight and a pharmacist should be consulted for help.

Herbal treatments
In Mexico, it is common to use herbal tinctures of chaparro amargo (English: castela). 30 drops are taken in a small glass of water first thing in the morning, and 30 drops before the last meal of the day, for seven days straight. After taking a seven day break from the treatment, it is resumed for seven days. Some mild cramping may be felt; it is claimed this means that the amoebas are dying and will be expelled from the body. Many Mexicans use the chaparro amargo treatment regularly, three times a year. The efficacy of such treatments has not been scientifically proven.

A 1998 study in Africa suggests that 2 tablespoons per week of papaya seeds may have some antiamoebic action and aid in prevention of amoebiasis, but this remains unconfirmed. Papaya fruit and seeds are often considered beneficial to digestion in areas where this plant is common.