Short-term follow-up studies in amoebic dysentery

The findings at discharge and at one-month follow-up were compared in groups of patients with acute amoebic dysentery who had received either direct-acting amoebicides or broad-spectrum antibiotics or a combination of these drugs. Among patients discharged as cured, follow-up revealed no significant difference between those who had received direct-acting amoebicides and those treated with antibiotics in the incidence of relapse, conversion to cyst-passing and recurrence of rectal ulceration. There was, however, a high relapse rate among patients treated with antibiotics and rendered symptom-free with disappearance of amoebae, but with persistent rectal ulceration on discharge. Among patients who had become asymptomatic cyst-passers there was a similar and high relapse rate in both those who had received direct-acting amoebicides and in those treated with antibiotics. Amoebic dysentery should be treated with the combination of a direct-acting, systemically effective amoebicide and a broad-spectrum antibiotic.