There was no significant difference in relation to the resolution of fever , abscess size , and hospital stay .
The beneficial effects of PA were seen with medium-to-large ( > 5 cm ) ALA and not with small ( < 5 cm ) ALA .
Percutaneous aspiration as compared with metronidazole alone results in the early resolution of pain and tenderness in patients with medium-to-large ALA .
Percutaneous catheter drainage is better for larger ALA .
The role of metronidazole alone , percutaneous aspiration ( PA ) , and percutaneous catheter drainage ( PCD ) in the treatment of uncomplicated amebic liver abscess ( ALA ) is still unclear .
This systematic review and meta- analysis evaluated the available evidence s with regard to treatment modalities in such patients .
Comparative study of tinidazole versus metronidazole in treatment of amebic liver abscess: A randomized control trial
Background Metronidazole is a drug of choice for amebic liver abscess ( ALA ) , but has long course and significant side effects . Thus , drugs like tinidazole with a better tolerability record need evaluation . Methods We conducted a r and omized controlled trial at the Department of Gastroenterology , SMS Hospital , Jaipur , India . One hundred and fifty admitted patients were r and omized into two treatment groups , metronidazole ( group M , n = 75 ) and tinidazole ( group T , n = 75 ) . Patients were observed for clinical response , laboratory parameters , imaging , and side effects . Early clinical response ( ECR ) was defined as the absence of fever and abdominal pain within 72 h of treatment . Symptomatic clinical response ( SCR ) was defined as the absence of fever and abdominal pain irrespective of duration of treatment required . Follow up was done at 1 , 3 , and 6 months . Results ECR was 62.3 % in group T vs. 37.7 % in group M ( p = 0.02 ) . SCR was shorter in group T than group M ( 3.29 ± 1.61 days vs. 5.67 ± 2.93 , p ≤ 0.001 ) . Mean residual volume at the end of 1 month was lower in group T ( 130.7 ± 108.1 vs. 184.7 ± 143.3 mL , p = 0.01 ) and no significant difference was seen at 3 and 6 months  . Tinidazole was better tolerated with fewer side effects . Low socioeconomic status , baseline abscess volume > 500 mL , hypoalbuminemia , pleural effusion , and history of ethanol use were associated with a late clinical response on univariate analysis of which low socioeconomic status was the only associated factor . Conclusion Tinidazole , as compared to metronidazole , has early clinical response , shorter treatment course , favorable rate of recovery , and high tolerability ; thus , tinidazole can be preferred over metronidazole in ALA
There was no significant difference in relation to the resolution of fever , abscess size , and hospital stay .
The beneficial effects of PA were seen with medium-to-large ( > 5 cm ) ALA and not with small ( < 5 cm ) ALA .
Percutaneous aspiration as compared with metronidazole alone results in the early resolution of pain and tenderness in patients with medium-to-large ALA .
Percutaneous catheter drainage is better for larger ALA .
The role of metronidazole alone , percutaneous aspiration ( PA ) , and percutaneous catheter drainage ( PCD ) in the treatment of uncomplicated amebic liver abscess ( ALA ) is still unclear .
This systematic review and meta- analysis evaluated the available evidence s with regard to treatment modalities in such patients .