A prospective evaluation was made of the therapeutic efficacy of
paromomycin, an orally administered, nonabsorbable
aminoglycoside, in 114 homosexual men with mild-to-moderate (nondysenteric)
intestinal amebiasis. All patients received 25-35 mg/kg daily in three divided doses for seven days. Of the 80 patients with gastrointestinal complaints at the onset of
therapy, 55 (80%) of 69 were asymptomatic within four to six weeks after completion of treatment; 11 patients were lost to follow-up.
Paromomycin produced long-term eradication of intestinal Entameba histolytica
infection in 92% of all men evaluated. The rate of microbiologic cure among patients with symptoms at the onset of
therapy was comparable to that among asymptomatic individuals.
Paromomycin was well tolerated, with mild
diarrhea during
therapy the only frequent adverse effect (67% of patients). Thus,
paromomycin is an effective alternative to conventional multi-
drug therapy for
intestinal amebiasis, and it has the advantages of low toxicity, brief
duration of therapy, and a high rate of patient compliance.