Chloroquine is directly toxic to E. histolytica trophozoites and is highly concentrated within the liver, making it effective for amebic liver abscess. It is used only when metronidazole or another nitroimidazole is either contraindicated or unavailable. Chloroquine is not effective against intestinal amebiasis because it only attains low concentrations in the colon; patients receiving chloro-quine for amebic liver abscess also should receive paromomycin or iodoquinol to eliminate intestinal colonization.
The conventional course of treatment with chloroquine for extraintestinal amebiasis in adults is 1 g/day for 2 days, followed by 500 mg/day for at least 2—3 weeks. Because of its low toxicity, this dose can be increased or the schedule can be repeated if necessary.
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