Document Detail


An update on pharmacotherapy for leishmaniasis.
MedLine Citation:
PMID:  25346016     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction: Leishmaniasis broadly manifests as visceral leishmaniasis (VL), cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis. The treatment of leishmaniasis is challenging and the armamentarium of drugs is small, duration of treatment is long, and most drugs are toxic. Areas covered: A literature search on treatment of leishmaniasis was done on PubMed. Single dose of liposomal amphotericin B (L-AmB) and multidrug therapy (L-AmB + miltefosine, L-AmB + paromomycin (PM), or miltefosine + PM) are the treatment of choice for VL in the Indian subcontinent. A 17-day combination therapy of pentavalent antimonials (Sb(v)) and PM remains the treatment of choice for East African VL. L-AmB at a total dose of 18 - 21 mg/kg is the recommended regimen for VL in the Mediterranean region and South America. Treatment of CL should be decided by the severity of clinical lesions, etiological species and its potential to develop into mucosal leishmaniasis. Expert opinion: There is an urgent need to implement a single-dose L-AmB or combination therapy in the Indian subcontinent. Shorter and more acceptable regimens are needed for the treatment of post - kala-azar dermal leishmaniasis. Combination therapy with newer drugs needs to be tested in Africa. Due to the toxicity of systemic therapy, a trend toward local treatment for New World CL is preferred in patients without risk of mucosal disease.
Authors:
Shyam Sundar; Jaya Chakravarty
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-25
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  -     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-27     Completed Date:  -     Revised Date:  2014-10-28    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-16     Citation Subset:  -    
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