Amebic liver abscess is the commonest extra-intestinal manifestations of amebiasis. When patients are symptomatic, fever and right upper quadrant pain are the usual manifestations. Point tenderness over the liver with or without right side pleural effusion is also common.

Treatment

Non-Drug treatment

Aspiration of the abscess can be done when ever necessary.

Drug treatment

First line:

Metronidazole, 750 mg, p.o. tid or 500 mg IV every 6 hr, for 10 days. For children: 7.5 mg/kg, p.o. tid, for 5 days. (For S/E, C/I and dosage forms, see page 1)

OR

Tinidazole, 2g p.o. stat, for 3 consecutive days. For Children: 50-60mg/kg daily for 3 days. (For S/E, C/I and dosage forms, see page 1)

PLUS

Diloxanide furoate, 500 mg tid for 10 days. For children over 25 kg, 20 mg/kg daily in 3 divided doses for 10 days.

(For S/E, C/I and dosage forms, see above)

Alternative:

Dehydroemetine, 1 mg/kg/24hrs, in a single dose sc or im for 8 - 10 days

S/E: precardial pain, ECG changes, hypertension, polyneuritis.

C/I: organic heart disease; primary muscular or neurological diseases.

Dosage forms: injection, 150 mg base in 5 ml ampoule.

PLUS

Chloroquine, 500 mg bid for 2 days then 500 mg daily for 21 days.

S/E: dizziness, GI discomfort and pruritus.

C/I: alcoholism, history of hypersensitivity, epilepsy and psoriasis.

D/I: antacids reduce absorption and cimetidine reduces metabolism.

Dosage forms: tablet, 150 mg base; syrup 50 mg base /5ml.Injection, 150 mg base in 5 ml ampoule.

PLUS

Diloxanide furoate, 500 mg, tid for 10 days. (For S/E, C/I and dosage forms, see page 2)