Is paromomycin the drug of choice for eradication of Dientamoeba fragilis in adults?

Dientamoeba fragilis is a debated protozoan parasite that is often detected in stools of patients with chronic gastro-intestinal complaints. A retrospective follow-up study of a large cohort of patients was performed to better understand the natural course of the infection and possible treatment options. D. fragilis was spontaneously cleared in 41% of untreated cases. With an eradication rate of 98%, treatment with paromomycin appeared more effective than treatment with clioquinol (83%) or metronidazole (57%).

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• Study on efficacy of drugs and natural course to eradicate Dientamoeba fragilis.
• Paromomycin treatment eradicated Dientamoeba fragilis in 60/61 patients (98%).
• D. fragilis infections were spontaneously cleared in 9/22 untreated patients (41%).