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Related to paromomycin: metronidazole, Paromomycin sulfate


a broad-spectrum antibiotic derived from Streptomyces rimosus var. paromomycinus; the sulfate salt is used as an antiamebic.




Therapeutic: amebicide
Pregnancy Category: C


Treatment of acute and chronic intestinal amebiasis.Management of hepatic coma as adjunctive therapy.


Inhibits protein synthesis in bacteria at level of 30S ribosome.

Therapeutic effects

Resolution of amebic infections.
Notable for activity against:
  • Entamoeba histolytica,
  • Dientamoeba fragilis,
  • Diphyllobothrium latum,
  • Taenia saginata,
  • Cryptosporidium,
  • Giardia lamblia.


Absorption: Minimal to no systemic absorption.
Distribution: Unknown.
Metabolism and Excretion: 100% excreted in feces.
Half-life: Unknown.

Time/action profile



Contraindicated in: Hypersensitivity to paromomycin or other aminoglycosides; Intestinal obstruction.
Use Cautiously in: Renal impairment; Ulcerative bowel lesions; Obstetric / Lactation / Pediatric: Safety not established.

Adverse Reactions/Side Effects


  • abdominal cramps
  • diarrhea
  • nausea
  • vomiting


  • hypersensitivity reactions


Interactions are listed for systemically absorbed drug

Drug-Drug interaction

May enhance possible respiratory paralysis after inhalation anesthetics or neuromuscular blockers.↑ risk of ototoxicity with loop diuretics.May ↑ the anticoagulant effects of warfarin.May ↓ the absorption of digoxin and methotrexate.


Intestinal Amebiasis

Oral (Adults and Children) 8.33–11.67 mg/kg 3 times daily with meals for 5–10 days.

Hepatic Coma

Oral (Adults) 4 g/day in 2–4 divided doses for 5–6 days.

Availability (generic available)

Capsules: 250 mg

Nursing implications

Nursing assessment

  • Assess patient for infection (vital signs, stool) at beginning of and periodically throughout therapy.
  • Hepatic Coma: Monitor neurologic status. Prior to administering oral medication, assess patient's ability to swallow.

Potential Nursing Diagnoses

Risk for infection (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)


  • Keep patient well hydrated (1500–2000 mL/day) during therapy.
  • Oral: Administer with meals.

Patient/Family Teaching

  • Instruct patient to take as directed for full course of therapy. Missed doses should be taken as soon as possible if not almost time for next dose; do not double doses.
  • Advise patient of the importance of drinking plenty of liquids.
  • Caution patient that medication may cause nausea, vomiting, or diarrhea.
  • Advise patient to notify health care professional if ringing in the ears, hearing impairment, or dizziness occurs.

Evaluation/Desired Outcomes

  • Resolution of amebic infection.
  • Improved neurologic status in hepatic coma.


/par·o·mo·my·cin/ (par´ah-mo-mi″sin) a broad-spectrum antibiotic derived from Streptomyces rimosus var. paromomycinus; the sulfate salt is used as an antiamebic.


a broad-spectrum antibiotic derived from Streptomyces rimosus var. paromomycinus; poorly absorbed after oral administration, it is used for intestinal infections. Called also aminosidine.
References in periodicals archive ?
Clearance of giardia after nitroimidazole treatment failure was achieved for < 20% of patients who received albendazole and < 30% of patients who received paromomycin, despite reported cure rates of 80% (7) and 90% (8), respectively, for these drugs when used as primary regimens.
Regarding cytotoxicity, pure oleuropein was less toxic to mammalian cells when compared with the standard drugs although paromomycin and HePC exhibited powerful activity against the amastigote forms of the parasite.
Extra chromosomal inheritance of paromomycin resistance in Saccharomyces cerevisiae.
McAuley JB, Juranek DD, Paromomycin in the treatment of mild-to-moderate intestinal amebiasis.
Activity of a paromomycin hydrophilic formulation for topical treatment of infections by Leishmania (Leishmania) amozonerisis and Leishmania (Virginia) braziliensis.
Amphotericin B and paromomycin were used for treating patients.
OneWorld Health (OWH), a nonprofit organization dedicated to developing lifesaving medicines for neglected diseases, announced that its antibiotic Paromomycin Intramuscular Injection (PMIM), developed to treat visceral leishmaniasis (VL or kala-azar), has been registered by the government of Nepal.
About Paromomycin Intramuscular Injection - Paromomycin, an off-patent aminoglycoside antibiotic, is an established drug with an extensive history of use and a well-characterized safety profile.
From case detection and management to implementation of new treatment modalities, including liposomal amphotericin B (AmBisome) in monotherapy and several combination therapies - with AmBisome, miltefosine, and paromomycin - the project covers primary and secondary healthcare levels in the public, not-for-profit, and private sectors.
Thus, antimonies, aromatic diamidines or paromomycin sulphates, are associated to a varying degree with cytotoxic effects and important resistance phenomena (Antoniou et al.
There are now also alternative treatments for VL in India following the registration of miltefosine in 2002 (11) and paromomycin in 2006 (12).
In addition, all were treated for cyst carriage with paromomycin, a luminal amebicide.