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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.
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Comparison of topical paromomycin sulfate (twice/day) with intralesional meglumine antimoniate for the treatment of cutaneous leishmaniasis caused by L.
4%) of 17 patients who experienced nitroimidazole treatment failure were cured after treatment with nitazoxanide and paromomycin monotherapy, respectively.
Besides systemic treatment, local measures, such as cryotherapy, local excision of a small focus and topical treatment using 15% paromomycin ointment, have also been shown to be effective in some cases (1,11).
52 OLWE (c) 203 [+ or -] 57 196 [+ or -] 11 0,71 Drug Paromomycin 1.
Also, to be included, children must not have taken antiparasitic medications like nitazoxanide, corticosteroids or antibiotics like azithromycin or paromomycin, 15 days prior to the determination of the Cryptosporidium spp.
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The choice of drugs (pentavalent antimonials, amphotericin B, liposomal amphotericin B-Ambiosome, paromomycin, and miltefosine) has increased in the past decade, but there are numerous drawbacks to each of the treatments, such as difficulty to administer, length of treatment, toxicity, cost, and increasing parasitic resistance to treatment.
In the past decade, there have been several advances with the introduction of new therapies like liposomal amphotericin, paromomycin and oral miltefosine3-7.
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Metronidazole's rapid absorption limits its time in the intestine; therefore, other drugs such as paromomycin are used for treating intestinal infections.