Treatment options for visceral leishmaniasis: a systematic review of clinical studies done in India, 1980–2004

Olliaro, Piero; Guérin, Philippe J.; Gerstl, Sibylle; Haaskjold, Astrid Aga; Røttingen, John-Arne; Sundar, Shyam

doi:10.1016/s1473-3099(05)70296-6

Cited by 204 publications

(188 citation statements)

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“…Allopurinol was ineffective for cutaneous leishmaniasis (CL) in Colombia 30 . Combined therapies of allopurinol and antimonials with interferon have also been tried in limited studies 12,14,25 .…”

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confidence: 99%

“…Pentamidine isethionate (Pentacarinat®) at 2-4 mg/kg body weight/day for up to 15 days is an effective but potentially toxic option. Pentamidine has a number of side effects including hypotension, life-threatening hypoglycemia caused by pancreatic β-cell injury, and later insulin-dependent diabetes mellitus 5,13,14,17,21 . Aminosidine (Paromomycin), a parenterally administered aminoglycoside, (11 mg/kg daily for 21 days) has shown promise in some studies 12,14,25,26,29 .…”

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confidence: 99%

“…Pentamidine has a number of side effects including hypotension, life-threatening hypoglycemia caused by pancreatic β-cell injury, and later insulin-dependent diabetes mellitus 5,13,14,17,21 . Aminosidine (Paromomycin), a parenterally administered aminoglycoside, (11 mg/kg daily for 21 days) has shown promise in some studies 12,14,25,26,29 . The imidazoles ketoconazole and itraconazole have been used successfully in some cases, but primary failures occur and they are not recommended for general use 21,25 .…”

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confidence: 99%

“…Amphotericin B causes secondary effects such as renal disturbances, anemia, fever, malaise and hypokalemia 5,14,17,25 . During the past years, liposomes have been used to transport chemotherapeutic agents into macrophages, which are the target cells for Leishmania amastigotes, improving the efficacy of the treatment and reducing its toxicity 5,17,22,25 .…”

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confidence: 99%

“…Amphotericin B deoxycholate (Fungisone®) is effective but requires parenteral administration over prolonged periods and is associated with nephrotoxicity and other side effects. Various doses and durations of therapy have been used, 1.0 mg per kg body weight per day for 15 days or 1.0 mg per kg body weight every other day for 30 days being two alternatives 13,14,17,21 . Pentamidine isethionate (Pentacarinat®) at 2-4 mg/kg body weight/day for up to 15 days is an effective but potentially toxic option.…”

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confidence: 99%

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Two cases of visceral leishmaniasis in Colombia resistant to meglumine antimonial treatment

Vélez

Colmenares

Muñoz

2009

Rev. Inst. Med. trop. S. Paulo

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SUMMARYVisceral leishmaniasis (VL) affects over 500 000 people worldwide each year. The disease occurs in the Mediterranean basin, Central and South America and is caused by Leishmania infantum (syn L. chagasi). VL is an endemic disease in Colombia, particularly along the Caribbean coast and the Magdalena River Valley and 90% of VL cases occur in children under the age of five. The first line of treatment is chemotherapy with pentavalent antimonial compounds, including sodium stibogluconate (Pentostam®) and meglumine antimoniate (Glucantime®). These compounds are the ones most used in Colombia, at a dose of 20 mg/kg/day for 28 days. Nevertheless resistance of L. infantum to pentavalent antimonials is becoming an important problem.No cases of VL resistant to pentavalent antimonial compounds have previously been reported from Colombia. This report describes the two cases of VL resistance to antimonial compounds in a girl and a boy who did not respond to previous treatment with Pentacarinat® and Glucantime® regimens but were treated successfully with liposomal amphotericin B. Based on our findings, we recommend liposomal amphotericin B as the first line of treatment for VL due to its low toxicity, shorter administration period and the low price obtained by WHO.

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confidence: 99%