[Amebiasis. Medical treatment. Is there anything better than metronidazole?]

Since 1961, when Cosar pointed out for the first time that metronidazol was a useful pharmacological agent against E. histolytica, several authors have demonstrated its effectiveness against invasive amebiasis in its colonic or extraintestinal variety. The obtained results with metronidazol were so far better compared with the rest of the known amebecides, that in 1974, Elsdon Dew stated that a new era in the medical treatment of the amebiasis had started with the forthcoming use of the agent. However, the frequent and important adverse collateral effects produced in a good number of patients have forced to look for other nitroimidazole derivates, hopefully more efficient and, of course, better tolerated. Thus, the tinidazole, ornidazole, flunidazole, romidazole, ornidazole, flunidazole, dimetridazole, satranidazole, nitrimidazine, panidazole, have been tried and some others are still subject to experimentation, such as the Ro 7-0207 (alpha-chlorometil-2-metil-5-nitro-1-imidazol), the phexinidazole (HOE 239) and the CG 10213-Go from CIBA-Geigy and no significant advantage has been found over the metronidazol. The phexinidazole turned out to be twice as effective as the metronidazole in the experimental hepatic amebiasis of the golden hamster. This fact must be confirmed or discarded in the human hepatic amebiasis.