Volume 84, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Nitroimidazole antibiotics are the mainstay of treatment of invasive amebiasis; however, few comparative studies of applicable antibiotics are available. Evidence of sporadic clinical failure and rare reports of metronidazole resistance have led to the investigation of novel antiamebic therapeutics. The goal of this study was to examine drug efficacy in both and models of intestinal amebiasis. We studied six current and three novel drugs. Many drugs, including metronidazole, nitazoxanide, and nitazoxanide derivatives, were shown to be potently inhibitory . However, metronidazole remained the most effective , both in preventative and curative regimens, underscoring the value of animal models in evaluating future therapies.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Haque R, Huston CD, Hughes M, Houpt E, Petri WA, Jr, 2003. Amebiasis. N Engl J Med 348: 15651573.[Crossref] [Google Scholar]
  2. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, Keystone JS, Pandey P, Cetron MS, , 2006. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354: 119130.[Crossref] [Google Scholar]
  3. Walsh JA, , 1986. Problems in recognition and diagnosis of amebiasis: estimation of the global magnitude of morbidity and mortality. Rev Infect Dis 8: 228238.[Crossref] [Google Scholar]
  4. Cohen HG, Reynolds TB, , 1975. Comparison of metronidazole and chloroquine for the treatment of amoebic liver abscess. A controlled trial. Gastroenterology 69: 3541. [Google Scholar]
  5. Rossignol JF, Kabil SM, El-Gohary Y, Younis AM, , 2007. Nitazoxanide in the treatment of amoebiasis. Trans R Soc Trop Med Hyg 101: 10251031.[Crossref] [Google Scholar]
  6. Irusen EM, Jackson TF, Simjee AE, , 1992. Asymptomatic intestinal colonization by pathogenic Entamoeba histolytica in amebic liver abscess: prevalence, response to therapy, and pathogenic potential. Clin Infect Dis 14: 889893.[Crossref] [Google Scholar]
  7. Fujishima T, Nishise S, Ichihara M, Kobayashi S, Takeuchi T, , 2010. Difficulties in the treatment of intestinal amoebiasis in mentally disabled individuals at a Rehabilitation Institution for the Intellectually Impaired in Japan. Chemotherapy 56: 348352.[Crossref] [Google Scholar]
  8. Asgharpour A, Gilchrist C, Baba D, Hamano S, Houpt E, , 2005. Resistance to intestinal Entamoeba histolytica infection is conferred by innate immunity and Gr-1+ cells. Infect Immun 73: 45224529.[Crossref] [Google Scholar]
  9. Houpt ER, Glembocki DJ, Obrig TG, Moskaluk CA, Lockhart LA, Wright RL, Seaner RM, Keepers TR, Wilkins TD, Petri WA, Jr, 2002. The mouse model of amebic colitis reveals mouse strain susceptibility to infection and exacerbation of disease by CD4+ T cells. J Immunol 169: 44964503.[Crossref] [Google Scholar]
  10. Tchouaffi-Nana F, Ballard TE, Cary CH, Macdonald TL, Sifri CD, Hoffman PS, , 2010. Nitazoxanide inhibits biofilm formation by Staphylococcus epidermidis by blocking accumulation on surfaces. Antimicrob Agents Chemother 54: 27672774.[Crossref] [Google Scholar]
  11. Downey AS, Graczyk TK, Sullivan DJ, , 2009. In vitro activity of pyrvinium pamoate against Entamoeba histolytica and Giardia intestinalis using radiolabelled thymidine incorporation and an SYBR Green I-based fluorescence assay. J Antimicrob Chemother 64: 751754.[Crossref] [Google Scholar]
  12. Samarawickrema NA, Brown DM, Upcroft JA, Thammapalerd N, Upcroft P, , 1997. Involvement of superoxide dismutase and pyruvate:ferredoxin oxidoreductase in mechanisms of metronidazole resistance in Entamoeba histolytica . J Antimicrob Chemother 40: 833840.[Crossref] [Google Scholar]
  13. Wassmann C, Hellberg A, Tannich E, Bruchhaus I, , 1999. Metronidazole resistance in the protozoan parasite Entamoeba histolytica is associated with increased expression of iron-containing superoxide dismutase and peroxiredoxin and decreased expression of ferredoxin 1 and flavin reductase. J Biol Chem 274: 2605126056.[Crossref] [Google Scholar]
  14. Bansal D, Sehgal R, Chawla Y, Mahajan RC, Malla N, , 2004. In vitro activity of antiamoebic drugs against clinical isolates of Entamoeba histolytica and Entamoeba dispar. Ann Clin Microbiol Antimicrob 3: 2731.[Crossref] [Google Scholar]
  15. Seifert K, Duchene M, Wernsdorfer WH, Kollaritsch H, Scheiner O, Wiedermann G, Hottkowitz T, Eibl H, , 2001. Effects of miltefosine and other alkylphosphocholines on human intestinal parasite Entamoeba histolytica . Antimicrob Agents Chemother 45: 15051510.[Crossref] [Google Scholar]
  16. Navarrete-Vazquez G, Cedillo R, Hernandez-Campos A, Yepez L, Hernadez-Luis F, Valdez J, Morales R, Cortes R, Hernandez M, Castillo R, , 2001. Synthesis and antiparasitic activity of 2-(trifluoromethyl)-benzimidazole derivatives. Bioorg Med Chem Lett 11: 187190.[Crossref] [Google Scholar]
  17. Makioka A, Kumagai M, Kobayashi S, Takeuchi T, , 2002. Possible role of calcium ions, calcium channels and calmodulin in excystation and metacystic development of Entamoeba invadens . Parasitol Res 88: 837843.[Crossref] [Google Scholar]
  18. Ranque S, Gazin P, Delmont J, , 2004. Schistosomiasis and tourism in the Dogon country, Mali. Med Trop (Mars) 64: 3132. [Google Scholar]
  19. Abid M, Azam A, , 2005. 1-N-substituted thiocarbamoyl-3-phenyl-2-pyrazolines: synthesis and in vitro antiamoebic activities. Eur J Med Chem 40: 935942.[Crossref] [Google Scholar]
  20. Sawangjaroen N, Phongpaichit S, Subhadhirasakul S, Visutthi M, Srisuwan N, Thammapalerd N, , 2006. The anti-amoebic activity of some medicinal plants used by AIDS patients in southern Thailand. Parasitol Res 98: 588592.[Crossref] [Google Scholar]
  21. Tasanor O, Brem B, Leitsch D, Binder M, Duchene M, Greger H, Wernsdorfer WH, , 2007. Development of a pharmacodynamic screening model with Entamoeba histolytica . Wien Klin Wochenschr 119: 8895.[Crossref] [Google Scholar]
  22. Bhat AR, Athar F, Azam A, , 2009. New derivatives of 3,5-substituted-1,4,2-dioxazoles: synthesis and activity against Entamoeba histolytica . Eur J Med Chem 44: 926936.[Crossref] [Google Scholar]
  23. Neal RA, , 1983. Experimental amoebiasis and the development of anti-amoebic compounds. Parasitology 86: 175191.[Crossref] [Google Scholar]
  24. Kimura M, Nakamura T, Nawa Y, , 2007. Experience with intravenous metronidazole to treat moderate-to-severe amebiasis in Japan. Am J Trop Med Hyg 77: 381385. [Google Scholar]
  25. Kaur J, Mathur TN, , 1972. Comparative drug trials in symptomatic and asymptomatic non-dysenteric amoebic colitis. Indian J Med Res 60: 15471553. [Google Scholar]
  26. Downey AS, Chong CR, Graczyk TK, Sullivan DJ, , 2008. Efficacy of pyrvinium pamoate against Cryptosporidium parvum infection in vitro and in a neonatal mouse model. Antimicrob Agents Chemother 52: 31063112.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 13 Oct 2010
  • Accepted : 05 Nov 2010
  • Published online : 05 Apr 2011

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error