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Comparison of regimes of treatment of antimony-resistant kala-azar patients: a randomized study.
Am J Trop Med Hyg. 1991 Oct; 45(4):435-41.AJ

Abstract

Three hundred twelve patients with antimony-resistant kala-azar were randomized into three groups. The first group (A) received pentamidine isethionate intravenously three times each week until parasitological cure was achieved. Group B received pentamidine concomitantly with a 20-day regimen of sodium stibogluconate. Group C received pentamidine injections that were followed by 20 days of sodium stibogluconate therapy. All patients became afebrile after 10 injections of pentamidine. Parasitologic cure was achieved in approximately 98% of the patients who had 33 or more injections of this drug. The addition of the antimony compound did not appear to enhance the rate of parasitologic cure. Three patients continued to have parasites after 40 injections of pentamidine. After six months, the rate of parasitologic cure was significantly higher in Group C (pentamidine followed by sodium stibogluconate) than in either Group A or B. Forty patients relapsed after apparent parasitologic cure and were successfully treated with five additional injections of pentamidine, followed by a course of antimony therapy. Minor side effects with pentamidine included an uneasy feeling during intravenous injection (12%), intestinal disturbances (6%), cellulitis (5%), abscess formation (1%), and allergic manifestations (2%). Major reactions to this drug included hyperglycemia (10%; reversible in 6% and irreversible in 4%), and delayed hypoglycemia (8%). Four deaths were associated with the administration of this compound. It is concluded that pentamidine is an effective but toxic drug for the treatment of antimony-resistant kala-azar.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Patna Medical College and Hospital, Patna, Bihar, India.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

1659239

Citation

Thakur, C P., et al. "Comparison of Regimes of Treatment of Antimony-resistant Kala-azar Patients: a Randomized Study." The American Journal of Tropical Medicine and Hygiene, vol. 45, no. 4, 1991, pp. 435-41.
Thakur CP, Kumar M, Pandey AK. Comparison of regimes of treatment of antimony-resistant kala-azar patients: a randomized study. Am J Trop Med Hyg. 1991;45(4):435-41.
Thakur, C. P., Kumar, M., & Pandey, A. K. (1991). Comparison of regimes of treatment of antimony-resistant kala-azar patients: a randomized study. The American Journal of Tropical Medicine and Hygiene, 45(4), 435-41.
Thakur CP, Kumar M, Pandey AK. Comparison of Regimes of Treatment of Antimony-resistant Kala-azar Patients: a Randomized Study. Am J Trop Med Hyg. 1991;45(4):435-41. PubMed PMID: 1659239.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of regimes of treatment of antimony-resistant kala-azar patients: a randomized study. AU - Thakur,C P, AU - Kumar,M, AU - Pandey,A K, PY - 1991/10/1/pubmed PY - 1991/10/1/medline PY - 1991/10/1/entrez SP - 435 EP - 41 JF - The American journal of tropical medicine and hygiene JO - Am J Trop Med Hyg VL - 45 IS - 4 N2 - Three hundred twelve patients with antimony-resistant kala-azar were randomized into three groups. The first group (A) received pentamidine isethionate intravenously three times each week until parasitological cure was achieved. Group B received pentamidine concomitantly with a 20-day regimen of sodium stibogluconate. Group C received pentamidine injections that were followed by 20 days of sodium stibogluconate therapy. All patients became afebrile after 10 injections of pentamidine. Parasitologic cure was achieved in approximately 98% of the patients who had 33 or more injections of this drug. The addition of the antimony compound did not appear to enhance the rate of parasitologic cure. Three patients continued to have parasites after 40 injections of pentamidine. After six months, the rate of parasitologic cure was significantly higher in Group C (pentamidine followed by sodium stibogluconate) than in either Group A or B. Forty patients relapsed after apparent parasitologic cure and were successfully treated with five additional injections of pentamidine, followed by a course of antimony therapy. Minor side effects with pentamidine included an uneasy feeling during intravenous injection (12%), intestinal disturbances (6%), cellulitis (5%), abscess formation (1%), and allergic manifestations (2%). Major reactions to this drug included hyperglycemia (10%; reversible in 6% and irreversible in 4%), and delayed hypoglycemia (8%). Four deaths were associated with the administration of this compound. It is concluded that pentamidine is an effective but toxic drug for the treatment of antimony-resistant kala-azar.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0002-9637 UR - https://www.unboundmedicine.com/medline/citation/1659239/Comparison_of_regimes_of_treatment_of_antimony_resistant_kala_azar_patients:_a_randomized_study_ L2 - https://ajtmh.org/doi/10.4269/ajtmh.1991.45.435 DB - PRIME DP - Unbound Medicine ER -