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A comparison of liposomal amphotericin B with sodium stibogluconate for the treatment of visceral leishmaniasis in pregnancy in Sudan.
J Antimicrob Chemother. 2006 Oct; 58(4):811-5.JA

Abstract

OBJECTIVES

Little is known about the treatment of visceral leishmaniasis (VL) in pregnancy, especially in resource-poor settings. We present a series of pregnant women with VL treated with either sodium stibogluconate or liposomal amphotericin B (AmBisome), or both, in eastern Sudan over 16 months.

METHODS

We did a retrospective analysis of all pregnant VL patients treated in the Médecins sans Frontières (MSF) Um el Kher centre between January 2004 and April 2005. We diagnosed VL with laboratory confirmation of clinical suspects, and recorded the outcomes of treatment for pregnant women and their foetuses. We carried out a manual search of relevant publications and a systematic search of the literature in the MEDLINE database.

RESULTS

We treated 23 women with sodium stibogluconate, 4 with AmBisome and sodium stibogluconate and 12 with AmBisome alone. There were 13 (57%) spontaneous abortions in the sodium stibogluconate monotherapy group, and none in either of the other two groups. All spontaneous abortions occurred in the first two trimesters. All patients, except one in the sodium stibogluconate group who defaulted, were discharged as cured in good clinical condition.

CONCLUSIONS

AmBisome treatment for VL appears to be safe and effective for pregnant women and their foetuses. We recommend the use of AmBisome as first-line treatment for these patients.

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Authors+Show Affiliations

Mueller M
Médecins sans Frontières, 67-74 Saffron Hill, London EC1N 8QX, UK.
Balasegaram M
No affiliation info available
Koummuki Y
No affiliation info available
Ritmeijer K
No affiliation info available
Santana MR
No affiliation info available
Davidson R
No affiliation info available

MeSH

Abortion, SpontaneousAdolescentAdultAmphotericin BAnimalsAntimony Sodium GluconateAntiprotozoal AgentsDrug Therapy, CombinationFemaleHumansInfant, NewbornLeishmaniasis, VisceralMiddle AgedPregnancyPregnancy Complications, ParasiticSudanTreatment Outcome

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16916865

Citation

Mueller, Marius, et al. "A Comparison of Liposomal Amphotericin B With Sodium Stibogluconate for the Treatment of Visceral Leishmaniasis in Pregnancy in Sudan." The Journal of Antimicrobial Chemotherapy, vol. 58, no. 4, 2006, pp. 811-5.
Mueller M, Balasegaram M, Koummuki Y, et al. A comparison of liposomal amphotericin B with sodium stibogluconate for the treatment of visceral leishmaniasis in pregnancy in Sudan. J Antimicrob Chemother. 2006;58(4):811-5.
Mueller, M., Balasegaram, M., Koummuki, Y., Ritmeijer, K., Santana, M. R., & Davidson, R. (2006). A comparison of liposomal amphotericin B with sodium stibogluconate for the treatment of visceral leishmaniasis in pregnancy in Sudan. The Journal of Antimicrobial Chemotherapy, 58(4), 811-5.
Mueller M, et al. A Comparison of Liposomal Amphotericin B With Sodium Stibogluconate for the Treatment of Visceral Leishmaniasis in Pregnancy in Sudan. J Antimicrob Chemother. 2006;58(4):811-5. PubMed PMID: 16916865.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of liposomal amphotericin B with sodium stibogluconate for the treatment of visceral leishmaniasis in pregnancy in Sudan. AU - Mueller,Marius, AU - Balasegaram,Manica, AU - Koummuki,Youssif, AU - Ritmeijer,Koert, AU - Santana,Muriel Ramirez, AU - Davidson,Robert, Y1 - 2006/08/17/ PY - 2006/8/19/pubmed PY - 2006/11/4/medline PY - 2006/8/19/entrez SP - 811 EP - 5 JF - The Journal of antimicrobial chemotherapy JO - J Antimicrob Chemother VL - 58 IS - 4 N2 - OBJECTIVES: Little is known about the treatment of visceral leishmaniasis (VL) in pregnancy, especially in resource-poor settings. We present a series of pregnant women with VL treated with either sodium stibogluconate or liposomal amphotericin B (AmBisome), or both, in eastern Sudan over 16 months. METHODS: We did a retrospective analysis of all pregnant VL patients treated in the Médecins sans Frontières (MSF) Um el Kher centre between January 2004 and April 2005. We diagnosed VL with laboratory confirmation of clinical suspects, and recorded the outcomes of treatment for pregnant women and their foetuses. We carried out a manual search of relevant publications and a systematic search of the literature in the MEDLINE database. RESULTS: We treated 23 women with sodium stibogluconate, 4 with AmBisome and sodium stibogluconate and 12 with AmBisome alone. There were 13 (57%) spontaneous abortions in the sodium stibogluconate monotherapy group, and none in either of the other two groups. All spontaneous abortions occurred in the first two trimesters. All patients, except one in the sodium stibogluconate group who defaulted, were discharged as cured in good clinical condition. CONCLUSIONS: AmBisome treatment for VL appears to be safe and effective for pregnant women and their foetuses. We recommend the use of AmBisome as first-line treatment for these patients. SN - 0305-7453 UR - https://www.unboundmedicine.com/medline/citation/16916865/A_comparison_of_liposomal_amphotericin_B_with_sodium_stibogluconate_for_the_treatment_of_visceral_leishmaniasis_in_pregnancy_in_Sudan_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkl342 DB - PRIME DP - Unbound Medicine ER -