It is not effective in acute intestinal amoebiasis. Tetracycline and erythromycin have been shown to be indirectly amoebicidal. They act in the bowel wall and lumen by interfering with the enteric flora needed by amoebae for survival. They are not considered highly effective on their own but may be useful as adjuncts to other amoebicides for treating acute intestinal infestations. Chloroquine may be used in combination with an intestinal amoebicide in treating extraintestinal infections.
Action is mainly in the liver.
It is not considered a primary agent. Dehydroemetine and emetine have potentially severe adverse effects and have been superseded by metronidazole. They are both highly effective tissue amoebicides, active against amoebae in the bowel wall, liver and other tissues. On account of their toxicity they are used only for severe infections not responding to metronidazole. They are not readily available in South Africa.