PHARMACOLOGY

Paromomycin is a broad spectrum aminoglycoside antibiotic produced by S. rimosus var. paromomycinus. The drug is structurally related to neomycin, streptomycin and kanamycin.
It is poorly absorbed after oral administration with almost 100% of the drug recoverable in the stool.

Paromomycin is considered a luminal or contact amebicide since it acts principally in the
intestinal lumen. Unlike tetracyclines, paromomycin is a direct-acting amebicide and is effective
either in the presence or absence of bacteria.

Like other aminoglycosides, paromomycin is bactericidal and appears to inhibit protein synthesis
in susceptible bacteria at the 30S segment of the ribosome.

Paromomycin has a broad spectrum of activity, including activity against protozoa, bacteria and
cestodes. Paromomycin is active against protozoa, especially E. histolytica. The drug is believed
to act against both the trophozoite and encysted forms of Entamoeba.

Paromomycin has an antibacterial spectrum quite similar to that of neomycin and is bactericidal
to many normal and pathogenic organisms in the gastrointestinal tract.
Almost complete crossresistance exists between paromomycin and kanamycin, neomycin and streptomycin.

INDICATIONS

For intestinal amebiasis, acute and chronic. It is not effective in extraintestinal amebiasis.

CONTRAINDICATIONS

Individuals with a history of previous hypersensitivity reactions to paromomycin. It is also contraindicated in intestinal obstruction.

PRECAUTIONS

The use of this antibiotic, as with other antibiotics, may result in an overgrowth of nonsusceptible organisms, including fungi. Constant observation of the patient is essential.

If new infections caused by nonsusceptible organisms appear during therapy, appropriate measures should be taken.
The drug should be used with caution in individuals with ulcerative lesions of the bowel to avoid renal toxicity through inadvertent absorption.

ADVERSE EFFECTS

Nausea, abdominal cramps and diarrhea have been reported in patients on doses over 3 g daily.

DOSAGE

Adults and Children: Usual dose 25 to 35 mg/kg body weight daily, administered in 3 doses with meals, for 5 to 10 days.

SUPPLIED

Each capsule with yellow body and brown cap, imprinted with “Parke-Davis” contains: paromomycin sulfate equivalent to paromomycin 250 mg.

Nonmedicinal ingredients:
colloidal silica and magnesium stearate. Capsule shell: black iron oxide, gelatin, red iron oxide, titanium dioxide and yellow iron oxide. Bottles of 100. Store at controlled room temperature 15 to 25°C. Protect from moisture.