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An update on pharmacotherapy for leishmaniasis.
Expert Opin Pharmacother. 2015 Feb; 16(2):237-52.EO

Abstract

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.

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Authors+Show Affiliations

Sundar S
Banaras Hindu University, Institute of Medical Sciences, Department of Medicine , Varanasi , India +91 542 2369632 ; drshyamsundar@hotmail.com.
Chakravarty J
No affiliation info available

MeSH

CryotherapyDrug Therapy, CombinationHumansHyperthermia, InducedLeishmaniasisNeglected DiseasesPractice Guidelines as TopicTrypanocidal Agents

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Review

Language

eng

PubMed ID

25346016

Citation

Sundar, Shyam, and Jaya Chakravarty. "An Update On Pharmacotherapy for Leishmaniasis." Expert Opinion On Pharmacotherapy, vol. 16, no. 2, 2015, pp. 237-52.
Sundar S, Chakravarty J. An update on pharmacotherapy for leishmaniasis. Expert Opin Pharmacother. 2015;16(2):237-52.
Sundar, S., & Chakravarty, J. (2015). An update on pharmacotherapy for leishmaniasis. Expert Opinion On Pharmacotherapy, 16(2), 237-52. https://doi.org/10.1517/14656566.2015.973850
Sundar S, Chakravarty J. An Update On Pharmacotherapy for Leishmaniasis. Expert Opin Pharmacother. 2015;16(2):237-52. PubMed PMID: 25346016.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An update on pharmacotherapy for leishmaniasis. AU - Sundar,Shyam, AU - Chakravarty,Jaya, Y1 - 2014/10/25/ PY - 2014/10/28/entrez PY - 2014/10/28/pubmed PY - 2015/5/12/medline KW - cutaneous leishmaniasis KW - kala azar KW - leishmaniasis KW - visceral leishmaniasis SP - 237 EP - 52 JF - Expert opinion on pharmacotherapy JO - Expert Opin Pharmacother VL - 16 IS - 2 N2 - 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. SN - 1744-7666 UR - https://www.unboundmedicine.com/medline/citation/25346016/An_update_on_pharmacotherapy_for_leishmaniasis_ DB - PRIME DP - Unbound Medicine ER -