Treatment of amoebic liver abscess with tinidazole and metronidazole

20 patients with amoebic liver abscess, confirmed by aspiration of typical amoebic 'pus', were treated in random order with either tinidazole or metronidazole in a dose of 2g once daily for 2 days. Clinical, radiological, and biochemical follow-up was done for 1 month. One patient, given metronidazole, absconded and 19 completed the trial. Complete recovery occurred in all 10 patients given tinidazole but in only 5 of the 9 given metronidazole (p = 0.05). Patients on tinidazole required repeat aspirations less frequently than those on metronidazole. Mild gastrointestinal side-effects occurred in 1 patient on metronidazole but in none on tinidazole. From the present study, tinidazole appears to be a more effective, better tolerated drug with a more rapid therapeutic effect than metronidazole.