II. Indications

  1. Amebiasis (intestinal)
  2. Giardiasis (off-label)

III. Mechanism

  1. Aminoglycoside (Oligosaccharide) antibiotic derived from Streptomyces species
  2. Specifically binds RNA oligonucleotide at the A site of Bacterial 30S ribosomes
    1. Results in misreads and premature termination of translation
    2. Inhibits Protein synthesis, leading to cell death

IV. Dosing

  1. Take with food or after meals
  2. Amebiasis (Adults and Children)
    1. Paromomycin 25 to 35 mg/kg/day orally divided three times daily for 5 to 10 days
  3. Giardiasis (off-label) for adults and children)
    1. Adult: 500 mg orally three times daily for 7 days
    2. Child: 25 to 35 mg/kg/day orally divided three times daily taken for 7 days

V. Pharmacokinetics

  1. Not absorbed
    1. Absorption may occur in Inflammatory Bowel Disease, and secondary nephrotoxicity may occur

VI. Safety

  1. Not absorbed
  2. May be used in Lactation
  3. Pregnancy
    1. Unknown safety in first trimester
    2. May be used in later pregnancy

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