Amoebic liver abscess medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Medical Therapy

Pharmocotherapy for E histolytica include:

Site Of Infection	Treatment
Intraluminal infection	Iodoquinol 650mg tid X 20 days Diloxanide furoate 500mg tid X 20 days Paramomycin 30mg/kg/day X 10 days (in 3 divided doses)
Amoebic liver abscess	Metronidazole 800mg tid PO X 10days (500mg qid IV)
Invasive colitis	Metronidazole 800mg tid X 5 days Tinidazole 1 gm bd X 3 days

Current treatment recommendations of E histolytica includes

• With medical therapy alone, the cure rates of more than 90% have been reported, with the resolution of pain, fever, and anorexia with in 72h to 96h.

Treatment phase	Drug	Adult	Pediatric
Initial treatment of amoebic liver abscess	Metronidazole	750 mg PO TID × 7–10 days	35–50 mg/kg/day DIVIDED TID × 7–10 days
	Tinidazole	2 g once PO daily × 3 days	>3 years: 50 mg/kg/day (max 2 g) PO in 1 dose × 3 days
Clearance of luminal cysts	Iodoquinol	650 mg PO TID × 20 days	30–40 mg/kg/day DIVIDED TID × 20 days (max 2 g/day)
	Paromomycin	500 mg PO TID × 7 days OR 25–35 mg/kg/day DIVIDED TID × 7 days	25–35 mg/kg/day DIVIDED TID × 7 days

Antibiotic treatment Invasive therapeutic procedures 1: ultrasound guided needle aspiration, percutaneous catheter drainage, and open surgical abscess drainage