パロモマイシン
パロモマイシンは経口アミノグリコシド系抗生物質であり、獣医学においては主に**クリプトスポリジウム**や**リーシュマニア**に対する抗寄生虫作用を目的として使用されます。ネオマイシンと構造が似ており、消化管粘膜が正常な場合はほとんど吸収されないため、腸内病原体に対して局所的に作用します。 > **臨床上のポイント:** 腸内原虫には有効ですが、猫への使用は非常に議論の余地があります。明らかな消化管潰瘍がなくても、重篤な全身毒性（急性腎障害、耳毒性、失明など）を引き起こすという報告があるためです。多くの臨床医は、猫にはアジスロマイシンなどの代替療法の使用を好みます。
作用機序: Paromomycin binds to the **30S ribosomal subunit** of susceptible organisms → causes misreading of mRNA → inhibits protein synthesis, leading to cell death. In protozoa such as *Leishmania*, it is believed to target the mitochondria and ribosomes, disrupting cellular respiration and protein synthesis.
動物種別の用量
- Treatment of cryptosporidiosis in Camelids (crias) · 50 mg/kg · PO · once per day (assumed) · 5-10 days · Dosing interval not specified in original source, assumed once per day by Plumb.
- Treatment of cryptosporidiosis · 125-165 mg/kg · PO · twice daily · 5 days · Consider using an alternate treatment first (e.g., azithromycin) or paromomycin at an initially reduced dosage level.
- Treatment of cryptosporidiosis · 150 mg/kg · PO · once a day · 5 days · Caution: nephrotoxicity.
- Treatment of cryptosporidiosis · 150 mg/kg · PO · q12-24hr · Until 1 week past clinical resolution of diarrhea · If the cat is responding to the first 7 days of therapy and toxicity has not been noted.
- Treatment of cryptosporidiosis · 125-165 mg/kg · PO · twice daily · 5 days
- Treatment of cryptosporidiosis · 150 mg/kg · PO · once a day · 5 days · Caution: nephrotoxicity.
- Treatment of cryptosporidiosis · 300-800 mg/kg · PO · q24-48h · 7-14 days or as needed
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Known hypersensitivity to paromomycin
- Ileus or intestinal obstruction
- Gastrointestinal ulceration
- Presence of blood in the stool (indicates mucosal breakdown and risk of systemic absorption)
有害事象
- Nausea
- Vomiting
- Diarrhea
- Inappetence
- Nonsusceptible bacterial or fungal overgrowth
- Nephrotoxicity (if systemically absorbed)
- Ototoxicity (if systemically absorbed)
- Pancreatitis (if systemically absorbed)
- Blindness (reported in cats)
薬物相互作用
- Digoxin · Paromomycin may reduce digoxin absorption
- Methotrexate · Paromomycin may reduce methotrexate absorption
モニタリング
- Clinical efficacy (resolution of diarrhea, negative fecal tests)
- Gastrointestinal adverse effects
- Renal function (especially if used in cats or if GI ulceration is suspected)
過量投与
Because paromomycin is not absorbed orally, acute overdose adverse effects should be limited to **gastrointestinal distress** (nausea, vomiting, diarrhea) in patients with an intact GI system. **Chronic overdoses** or administration in patients with compromised GI mucosa may lead to severe systemic toxicity, including nephrotoxicity, ototoxicity, and pancreatitis.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。