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Treatment of protozoal infections (Paromomycin (Side effects (Abdominal…
Treatment of protozoal infections
Giardia lamblia
Intestinal trophozoite is treated with metronidazole or tinidazole (single dose)
Cryptosporidium parvum
Drugs have been proposed for use (paromomycin, nitazoxanide and spiramycin) but there is limited evidence that any of these have an impact on the severity or duration of diarrhoea in the most immunocompromised patients
Entamoeba histolytica
Intestinal infection is treated with metronidazole
In chronic infection cysts will survive and cause relapse and are resistant to metronidazole
Chronic infection needs treatment with diloxanide furoate
Amoebic abscess requires treatment with metronidazole at higher and longer doses
Metronidazole
Originally an antiprotozoal angent
Under anaerobic conditions it generates toxic radicals that damage bacterial and protozoal DNA
Active against Entamoeba histolytica and Giardia lamblia
Penetrates well into tissue (hence its value in amoebic liver abscess)
Side effects
A metallic taste is common and can be hard to tolerate
Causes an acute nauseous reaction with alcohol
Diloxanide furoate
A luminal amoebicide
Side effects
Flatulence
Itchiness
Hives
Paromomycin
An aminoglycoside
Given orally
Not absorbed from the GI tract
Kills amoebic cystic stage
Side effects
Abdominal cramps
Diarrhoea
Heartburn
Nausea
Vomiting