Paromomycin

Paromomycin is an aminoglycoside antibiotic, first isolated from the microorganism Streptomyces rimosus in the 1950s. It is primarily used as an antiprotozoal agent to treat parasitic infections, including amebiasis, giardiasis, and leishmaniasis.

Chemistry

Paromomycin is a derivative of neomycin, and like other aminoglycosides, it consists of a number of amino sugars connected by glycosidic bonds. The compound is highly polar, which limits its distribution in the body and makes it poorly absorbed from the gastrointestinal tract.

Mechanism of action

Paromomycin works by binding to the ribosomal RNA of the parasite, interfering with protein synthesis. This causes the production of abnormal proteins that are non-functional or toxic to the parasite, leading to its death.

Clinical use

Paromomycin is used to treat a variety of parasitic infections. In the treatment of amebiasis and giardiasis, it is taken orally to act directly on the parasites in the gut. For leishmaniasis, it is given by injection.

Side effects

The most common side effects of paromomycin are related to the gastrointestinal system and include nausea, vomiting, and diarrhea. Because it is poorly absorbed, systemic side effects are rare but can include kidney damage and hearing loss.

Resistance

Resistance to paromomycin can occur and is usually due to changes in the parasite's ribosomal RNA that prevent the drug from binding. This is a growing concern, particularly in the treatment of leishmaniasis.

See also

• Aminoglycoside
• Antiprotozoal agent
• Amebiasis
• Giardiasis
• Leishmaniasis