Effect of pantoprazole as an adjunct to standard medical therapy in patients with uncomplicated amoebic liver abscess: A randomised pilot study.

Amoebic liver abscess (ALA), a common tropical infection, is caused by Entamoeba histolytica (EH). For decades, the first-line treatment for ALA has been metronidazole which has several drawbacks. The thioredoxin reductase enzyme in EH is essential for its anti-oxidative defence and survival during tissue invasion. Recently, the benzimidazole nucleus of proton pump inhibitors has been found to inhibit it quite effectively. An in vitro study found pantoprazole to be over 100 times more potent than metronidazole. We therefore conducted a randomised open-label pilot study, comparing adjunct pantoprazole with standard medical therapy in patients with uncomplicated ALA. We found this resulted in a shorter hospital stay and faster resolution of fever, abdominal pain, and leucocytosis, compared to standard therapy.