“…1 In Brazil, for a 60-kg adult patient, the estimated direct costs of treatment of VL with L-AmB at a cumulative dose of 21 mg/kg, including costs of drugs, remuneration of health professionals, consumables, personal protective equipment, and complementary tests, were USD 659.79 and USD 11,559.15 using the WHOnegotiated price and the price adopted by The Drug Regulation Board from National Health Surveillance Agency/Ministry of Health from Brazil, respectively. 33 As part of combination therapy, we decided to use a lower dose of MA (10 mg/kg per day) than the standard one (20 mg/ kg per day) recommended for monotherapy by guidelines and the package insert, based on previous successful reports of rescue therapy with antimony low dose in immunocompromised patients with VL caused by L. infantum. In the study by Morizot et al, 34 three immunocompromised patients (two HIV-infected patients with severe immunosuppression and a kidney transplant recipient with graft rejection), with VL unresponsive to L-AmB, either for therapeutic failure or for relapse, were given a 28-day course of antimony low dose (10 mg Sb 5+ /kg per day for the HIV-infected patients and 170 mg Sb 5+ per day, adjusted for renal clearance, for the kidney transplant recipient), resulting in rapid and sustained clinical and parasitological cure.…”