| PAROMOMYCIN SULFATE
Classifications: aminoglycoside antibiotic; amebicide; Therapeutic: antibiotic; amebicide
Pregnancy Category: C
250 mg capsules
Aminoglycoside antibiotic produced by certain strains of Streptomyces rimosus with broad spectrum of antibacterial activity closely paralleling that of kanamycin and neomycin.
Exerts direct bactericidal and amebicidal action, primarily in lumen of GI tract. Ineffective against extraintestinal amebiasis.
Acute and chronic intestinal amebiasis and to rid bowel of nitrogen-forming bacteria in patients with hepatic coma; used
preoperatively to suppress intestinal flora. Also tapeworm infestation.
Aminoglycoside hypersensitivity; intestinal obstruction; impaired kidney function; pregnancy (category C).
GI ulceration; renal failure, renal impairment; older adults; myasthenia gravis; parkinsonism.
Route & Dosage
Adult/Child: PO 2535 mg/kg divided in 3 doses for 510 d
Adult: PO 4 g/d in divided doses for 56 d
- Give after meals to prevent gastric distress.
Adverse Effects (≥1%)CNS:
Headache, vertigo. GI: Diarrhea, abdominal cramps,
steatorrhea, nausea, vomiting, heartburn,
secondary enterocolitis. Skin:
Exanthema, rash, pruritus. Special Senses:
Nephrotoxicity (in patients with GI inflammation or ulcerations). Body as a Whole:
Eosinophilia, overgrowth of nonsusceptible organisms.
Diagnostic Test Interference
Prolonged use of paromomycin may cause reduction in serum cholesterol.
May decrease absorption of cyanocobalamin.
Poorly from intact GI tract. Elimination:
Assessment & Drug Effects
- Monitor therapeutic effectiveness. Criterion of cure is absence of amoebae in stool specimens examined at weekly intervals
for 6 wk after completion of treatment, and thereafter at monthly intervals for 2 y.
- Monitor for appearance of a superinfection during therapy (see Appendix F).
- Lab test: baseline WBC with differential. Repeat if superinfection is suspected.
- Monitor closely patients with history of GI ulceration for nephrotoxicity and ototoxicity (see Appendix F). Drug absorption
can take place through diseased mucosa.
Patient & Family Education
- Do not prepare, process, or serve food until treatment is complete when receiving drug for intestinal amebiasis. Isolation
is not required.
- Practice strict personal hygiene, particularly hand washing after defecation and before eating food.