PAROMOMYCIN SULFATE

(par-oh-moe-mye'sin)

Humatin
Classifications: aminoglycoside antibiotic; amebicide;
Therapeutic: antibiotic; amebicide
Pregnancy Category: C

Availability

250 mg capsules

Action

Aminoglycoside antibiotic produced by certain strains of Streptomyces rimosus with broad spectrum of antibacterial activity closely paralleling that of kanamycin and neomycin.

Therapeutic Effect

Exerts direct bactericidal and amebicidal action, primarily in lumen of GI tract. Ineffective against extraintestinal amebiasis.

Uses

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.

Contraindications

Aminoglycoside hypersensitivity; intestinal obstruction; impaired kidney function; pregnancy (category C).

Cautious Use

GI ulceration; renal failure, renal impairment; older adults; myasthenia gravis; parkinsonism.

Route & Dosage

Intestinal Amebiasis
Adult/Child: PO 25–35 mg/kg divided in 3 doses for 5–10 d

Hepatic Coma
Adult: PO 4 g/d in divided doses for 5–6 d

Administration

Oral

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: Ototoxicity. Urogenital: 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.

Interactions

Drug: May decrease absorption of cyanocobalamin.

Pharmacokinetics

Absorption: Poorly from intact GI tract. Elimination: In feces.

Nursing Implications

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.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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