Specific anti – metabolic drugs are divided into five groups.
I. Amoebicides of universal action: metronidazole ( flagyl , tricho- sex) 0.5 g 3-4 times a day (7-10 days); tinidazole ( fasizhin ) inside 2 g once a day (3-5 days); furamide 2 g 3 times a day (5 days); atamizole ( mdiloxonide ) – a combined preparation ( metronidazole and furamide ) 2 tablets 3 times a day (5-7 days).
II. Direct-acting amoebocides (contact), effective in localizing amoebas in the intestinal lumen: a) derivatives of 8-hydroxyquinoline – quiniophon ( yatren ) 0.5 g 3 times a day (7-10 days), as well as enemas 200 ml 1 -2% aqueous solution at night, diiodokhin 0.25-0.3 g 2-4 times a day, enteroseptol 1-2 tablets 3-4 times a day after meals (10-12 days), 2 tablets intestopan 3 times a day after meals (10-12 days), b) arsenic derivatives – aminarson ( carbazone ) 0.25 g 2-3 times a day before meals (10 days), osarsol 0.25 g 3 times a day (3 days).
III. Indirect amoebocides effective in localizing amoebas in the lumen and intestinal wall: tetracycline, oxytetracycline , chlorotetra-cyclin 0.25 g 4 times a day (10 days) in combination with drugs of groups II and IV.
IV. Tissue amoebicides are effective in localizing amoebas in the wall of the intestine, liver, and also in other organs: emethine hydrochloride subcutaneously or intramuscularly 2% solution of 1-2 ml 1-2 times a day (5-7 days), dehydromethine (less toxic and 6 times more active from emetin) intramuscularly 1-2% solution of 0.08 g per day (10 days) or (rarely) by mouth 0.05 g 2 times a day (10 days), ambilgar by mouth in a daily dose of 25 mg / kg (7-10 days).
V. Tissue amoebocides , which primarily act on amoebas in the liver and other organs (not in the intestines!): Hingamine ( chloroquine , delagil ). Treatment is carried out for 28 days according to a special scheme. Of the above drugs, metronidazole , ambilgar , hingamine , which are most effective and relatively low toxic , as well as dehydromethine , are widely used . Treatment of patients with amoebiasis with specific drugs is carried out in several courses with a change of drug, regardless of the effectiveness of the course of the previous treatment. In the complex treatment of patients with amoebiasis, immunostimulants, desensitizing agents, antispasmodic, and bacterial drugs are also used. In large abscesses of internal organs, surgical intervention is used, especially if chemotherapy has been ineffective. Patients with skin amoebiasis are prescribed 10% ciniophon ointment.
Prevention of Amebiasis
Patients with amoebiasis are treated in a hospital. They are prescribed after a full clinical recovery, subject to 5-6 negative stool tests for protozoa. Reconvalescents are subject to dispensary observation in KIZ. The whole complex of sanitary and hygienic measures is used, as with other intestinal infections.
Active immunization against amoebiasis is not carried out.