Imidazole and metronidazole in the treatment of intestinal amoebiasis

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Abstract
Sixty adult patients with symptomatic intestinal amoebiasis and with Entamoeba histolytica present in stools were allocated at random to treatment with tinidazole or metronidazole, both administered in a dose of 2 g once daily for 3 consecutive days. The treatment period was extended inpatients with stools positive for Entamoeba histolytica on the day following the last treatment day. Fifty-six patients, 29 on tinidazole and 27 on metronidazole, completedthe trialas perthe protocol. Twenty-eightpatients(96.5%) on tinidazole and 15 (55.5 %) on metronidazole were cured. Parasitological cure with partial relief of symptoms was obtained in 1 (3.5 %) and 5 (18.5 %)patients on tinidazole andmetronidazole, respectively. Seven patients (26 %) on metronidazole were treatment failures. Treatment had to be extended beyond 3 days in 53 % of patients (8/15) on metronidazole as opposed to 11% (3/28) on tinidazole (p < 0.01). The total number of side-effects, their severity, and the types were more in the metronidazole group. No toxic effects due to either drug were recorded. Tinidazole provided significantly higher cure rates than metronidazole in the treatment of symptomatic intestinal amoebiasis (p < 0.01), and was better tolerated than metronidazole.

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