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[Therapy of leishmaniasis in France: consensus on proposed guidelines].
Presse Med. 2011 Feb; 40(2):173-84.PM

Abstract

Because it relies on potentially toxic, difficult-to-handle, or expensive compounds the therapy of leishmaniasis is still a complex issue in 2010, especially for visceral leishmaniasis in immuno-suppressed subjects, or in patients with cutaneous and mucosal involvement. This induces a wide diversity of observed therapeutic practices, some being sub-optimal. The Société de Pathologie Exotique organised a meeting dedicated to the therapy of leishmaniasis in France that led to the first consensus on therapeutic guidelines. Liposomal amphotericin B is the first-line option for visceral leishmaniasis both in immunocompetent, and immunosuppressed patients (cumulated doses of 20 mg/kg and 30-40 mg/kg, respectively). Secondary prophylaxis with either liposomal amphotericin B, pentamidine or meglumine antimoniate is proposed to patients with heavy immunosuppression until immunity has been restored for at least 6 months. While the efficacy of new topical formulations of paromomycin is being tested, patients with Old World cutaneous leishmaniasis may be left untreated, or be administered a combination of superficial cryotherapy plus intralesional antimony, or even--in complex situations--receive systemic therapy. The efficacy of a short course of pentamidine (L. guyanensis/L. panamensis) and a 20-day schedule of meglumine antimoniate (L. braziliensis) is solidly established. However, in well-defined situations, local therapy of New World cutaneous leishmaniasis is now considered acceptable.

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Publisher Full Text
linkinghub.elsevier.com
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Authors+Show Affiliations

Buffet PA
Université Paris 6, UMR945 47, hôpital Pitié-Salpêtrière, service de parasitologie-mycologie, boulevard de l'hôpital, 75651 Paris cedex 13, France. pierre.buffet@psl.aphp.fr
Rosenthal É
No affiliation info available
Gangneux JP
No affiliation info available
Lightburne E
No affiliation info available
Couppié P
No affiliation info available
Morizot G
No affiliation info available
Lachaud L
No affiliation info available
Marty P
No affiliation info available
Dedet JP
No affiliation info available
Société de Pathologie Exotique
No affiliation info available

MeSH

FranceHumansLeishmaniasisLeishmaniasis, CutaneousLeishmaniasis, Visceral

Pub Type(s)

Consensus Development Conference
English Abstract
Journal Article
Practice Guideline

Language

fre

PubMed ID

21106333

Citation

Buffet, Pierre A., et al. "[Therapy of Leishmaniasis in France: Consensus On Proposed Guidelines]." Presse Medicale (Paris, France : 1983), vol. 40, no. 2, 2011, pp. 173-84.
Buffet PA, Rosenthal É, Gangneux JP, et al. [Therapy of leishmaniasis in France: consensus on proposed guidelines]. Presse Med. 2011;40(2):173-84.
Buffet, P. A., Rosenthal, É., Gangneux, J. P., Lightburne, E., Couppié, P., Morizot, G., Lachaud, L., Marty, P., & Dedet, J. P. (2011). [Therapy of leishmaniasis in France: consensus on proposed guidelines]. Presse Medicale (Paris, France : 1983), 40(2), 173-84. https://doi.org/10.1016/j.lpm.2010.09.023
Buffet PA, et al. [Therapy of Leishmaniasis in France: Consensus On Proposed Guidelines]. Presse Med. 2011;40(2):173-84. PubMed PMID: 21106333.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Therapy of leishmaniasis in France: consensus on proposed guidelines]. AU - Buffet,Pierre A, AU - Rosenthal,Éric, AU - Gangneux,Jean-Pierre, AU - Lightburne,Edward, AU - Couppié,Pierre, AU - Morizot,Gloria, AU - Lachaud,Laurence, AU - Marty,Pierre, AU - Dedet,Jean-Pierre, AU - ,, Y1 - 2010/11/23/ PY - 2010/07/05/received PY - 2010/09/09/revised PY - 2010/09/15/accepted PY - 2010/11/26/entrez PY - 2010/11/26/pubmed PY - 2011/3/24/medline SP - 173 EP - 84 JF - Presse medicale (Paris, France : 1983) JO - Presse Med VL - 40 IS - 2 N2 - Because it relies on potentially toxic, difficult-to-handle, or expensive compounds the therapy of leishmaniasis is still a complex issue in 2010, especially for visceral leishmaniasis in immuno-suppressed subjects, or in patients with cutaneous and mucosal involvement. This induces a wide diversity of observed therapeutic practices, some being sub-optimal. The Société de Pathologie Exotique organised a meeting dedicated to the therapy of leishmaniasis in France that led to the first consensus on therapeutic guidelines. Liposomal amphotericin B is the first-line option for visceral leishmaniasis both in immunocompetent, and immunosuppressed patients (cumulated doses of 20 mg/kg and 30-40 mg/kg, respectively). Secondary prophylaxis with either liposomal amphotericin B, pentamidine or meglumine antimoniate is proposed to patients with heavy immunosuppression until immunity has been restored for at least 6 months. While the efficacy of new topical formulations of paromomycin is being tested, patients with Old World cutaneous leishmaniasis may be left untreated, or be administered a combination of superficial cryotherapy plus intralesional antimony, or even--in complex situations--receive systemic therapy. The efficacy of a short course of pentamidine (L. guyanensis/L. panamensis) and a 20-day schedule of meglumine antimoniate (L. braziliensis) is solidly established. However, in well-defined situations, local therapy of New World cutaneous leishmaniasis is now considered acceptable. SN - 2213-0276 UR - https://www.unboundmedicine.com/medline/citation/21106333/[Therapy_of_leishmaniasis_in_France:_consensus_on_proposed_guidelines]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0755-4982(10)00571-3 DB - PRIME DP - Unbound Medicine ER -