Metronidazole retention enema in the management of severe intestinal amoebiasis

Metronidazole is a drug of proven efficacy in amoebiasis; however its use is restricted in patients who cannot take the drug by mouth, because of severe complications of the disease. Preliminary studies in eight control subjects show that rapid absorption and high serum levels are achieved after rectal administration of 2 gm. of metronidazole in 200 ml. of normal saline. Six patients with severe intestinal amoebiasis treated with metronidazole retention enema are presented, and they illustrate the efficacy of the new method of therapy. The efficacy of metronidazole in anaerobic bacteriodes infection and its proven amoebicidal effcet also indicate the possible use of the metronidazole retention enema technique in bowel preparation for colonic surgery in developing countries.