Emetine hydrochloride and chloroquine in the treatment of children with amoebic liver abscess.

Scragg, J. N.; Powell, Steve

doi:10.1136/adc.41.219.549

Cited by 12 publications

(2 citation statements)

References 5 publications

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“…Emetine, as an isolated alkaloid, was used as an anti-infective agent from 1912 when Vedder [4] showed that the drug killed amoebae in vitro. It was one of the most widely used agents, orally or intramuscularly, in the treatment of both intestinal and extraintestinal amoebiasis [5][6][7][8] until metronidazole became available [5]. Emetine is structurally unrelated to metronidazole.…”

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Emetine, Ipecac, Ipecac Alkaloids and Analogues as Potential Antiviral Agents for Coronaviruses

Bleasel

Peterson

2020

Pharmaceuticals

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The COVID-19 coronavirus is currently spreading around the globe with limited treatment options available. This article presents the rationale for potentially using old drugs (emetine, other ipecac alkaloids or analogues) that have been used to treat amoebiasis in the treatment of COVID-19. Emetine had amongst the lowest reported half-maximal effective concentration (EC 50 ) from over 290 agents screened for the Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS) coronaviruses. While EC 50 concentrations of emetine are achievable in the blood, studies show that concentrations of emetine can be almost 300 times higher in the lungs. Furthermore, based on the relative EC 50 s of emetine towards the coronaviruses compared with Entamoeba histolytica, emetine could be much more effective as an anti-coronavirus agent than it is against amoebiasis. This paper also discusses the known side effects of emetine and related compounds, how those side effects can be managed, and the optimal method of administration for the potential treatment of COVID-19. Given the serious and immediate threat that the COVID-19 coronavirus poses, our long history with emetine and the likely ability of emetine to reach therapeutic concentrations within the lungs, ipecac, emetine, and other analogues should be considered as potential treatment options, especially if in vitro studies confirm viral sensitivity.

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Emetine, Ipecac, Ipecac Alkaloids and Analogues as Potential Antiviral Agents for Coronaviruses

Bleasel

Peterson

2020

Pharmaceuticals

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“…Because of the severity of the condition in the very young we were, in the past, reluctant to abandon parenteral emetine preparations entirely and felt it prudent to use these in combination with other amoebicides (Scragg and Powell, 1966, 1968, 1970. However, modern amoebicides, prompt diagnosis, adequate aspiration, and surgical drainage in selected instances have done much to improve the prognosis and we have shown a steadily falling mortality rate during the past 15 years.…”

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confidence: 99%

Tinidazole in treatment of amoebic liver abscess in children.

Scragg¹,

Proctor²

1977

Archives of Disease in Childhood

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SUMMARY Tinidazole as a single drug therapy given in a single dose daily for 5 or 3 days was put to rigorous test in malnourished children. Of 25 children with amoebic liver abscess, 23 were cured. The 2 remaining cases required surgical drainage followed by other amoebicides, one subsequently dying from complicating bronchopneumonia.In amoebic liver abscess age alone is a most important factor in prognosis and can readily affect evaluation of treatment. A liver abscess of medium size in an adult is relatively enormous in an infant and causes extensive liver destruction. Regardless of the nature of therapy, the mortality is higher in infants than in older children and adults.

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