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TREATMENT OF LEISHMANIASIS

Leishmaniasis is a protozoal disease caused by genus Leishmania and is transmitted by sand fly bite.

Leishmaniasis

Primary

Alternative

Cutaneous

Pentavalent antimony compound;
Sodium stibugluconate OR meglumineantimoniate:
Dose: 20mg/kg/day -20 days

Pentamidine: 2-3mg/kg IV or IM daily -4-7 days OR
Miltefosine: 25mg/kg/day PO- 28 days

Mucosal

Pentavalent antimony compound;
Sodium stibugluconate OR meglumineantimoniate:
Dose: 20mg/kg/day -28 days
OR
Liposomal amphotericin B with total cumulative dose of 20-60 mg/kg OR conventional amphotericin B 0.5-1 mg/kg IV daily to total dose of 20-40 mg/kg

Miltefosine: 25mg/kg/day PO- 28 days

Visceral/Kala-Azar

Liposomal amphotericin B:
3mg/kg IV once daily at days: 1-5,14 and21 OR at days 1-5, and 10 OR 10mg/kg at days1 and2

Pentavalent antimony compound (high resistance in India and Meditarranean;
Sodium stibugluconate OR meglumineantimoniate:
Dose: 20mg/kg/day -28 days
Miltefosine: 25mg/kg/day PO- 28 days
Conventional amphotericin B 1 mg/kg IV daily – 20 days

 

Widespread misuse has led to the emergence of resistance in pentavalent antimony compounds in the hyper endemic areas (up to 40-50% cases). Therefore the drug of choice in these areas is now amphotericin B.

Dr Naima Fasih

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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