Granulomatous amoebic encephalitis (GAE)
A combination of drugs is preferred over the use of just a single drug. The following have been used with varying success: miltefosine, fluconazole, pentamidine, trimethoprim-sulfamethoxazole, metronidazole, azithromycin, clarithromycin, amphotericin B, rifampicin, itraconazole, caspofungin, sulfadiazine, and flucytosine. Single cerebral lesions should be removed by surgical excision, if possible.
Amoebic keratitis (AK)
Polyhexanide (PHMB), in low concentrations, and chlorhexidine are reported to be the most effective drugs for the treatment of AK. When used in combination, they appear to be effective against both the trophozoite and cyst stages. Both are to be administered every hour after corneal debridement for up to three days. Depending on the response, the frequency of administration may then be reduced to every three hours. It may be up to two weeks before any response is observed. Recommended duration of therapy varies from 3-4 weeks to 6-12 months. Enucleation may be required in severe cases.
Cutaneous acanthamoebiasis
The treatment regimen is similar to that for GAE. The skin lesions are very difficult to treat and even more so if there is central nervous system involvement.
