Children with Amoebic Liver Abscess

A combination of emetine hydrochloride with chloroquine yields better results than either drug alone in the treatment of amoebic liver abscess in adults (Wilmot, Powell, and Adams, 1959). A similar combination of dehydroemetine with chloroquine is equally satisfactory (Wilmot, Powell, MacLeod, and Elsdon-Dew, 1964; Powell, Wilmot, MacLeod, and Elsdon-Dew, 1967). Dehydroemetine is claimed to be less cardiotoxic than emetine (Schwartz and Herrero, 1965), and in adults it produces fewer electrocardiographic changes when given in identical dosage (Powell, 1967) so that up to 2 mg./kg. day have been given with apparent safety (Powell, Wilmot, MacLeod, and Elsdon-Dew, 1965). In children, amoebic liver abscess carries a high mortality (Scragg, 1960), but a comparative trial of emetine hydrochloride and chloroquine did not show that cardiac toxicity from emetine was a factor in causing death (Scragg and Powell, 1966). The results suggested that emetine was well tolerated by children and that, as in adults, emetine combined with chloroquine might provide the most effective treatment. The present trial reports the results of combining either emetine hydrochloride or dehydroemetine with chloroquine in children with amoebic liver abscess.