Abstract
PURPOSE OF REVIEW
This review summarizes recent important and interesting articles investigating the challenging treatment of the parasitic infection, leishmaniasis. In addition, it compares and contrasts leishmaniasis clinical practice treatment guidelines.
RECENT FINDINGS
Studies show that, in contrast to experience in India, visceral leishmaniasis in East Africa requires higher doses of liposomal amphotericin for effective treatment results and that pentavalent antimonial drugs remain efficacious. A retrospective study of visceral leishmaniasis in organ transplant patients suggests that there may be a role for secondary prophylaxis after treatment akin to HIV coinfection recommendations. The pros and cons of oral therapy with miltefosine, which cuts across leishmaniasis syndromes in its spectrum, are discussed. Cutaneous leishmaniasis clinical practice guidelines vary, although the recent European guidelines favor species-directed therapy.
SUMMARY
Leishmaniasis remains a neglected tropical disease, with a need for additional clinical trials with better design and reported endpoints to lead evidence-based treatment recommendations--especially in cutaneous leishmaniasis and leishmaniasis in the immunocompromised host.
TY - JOUR
T1 - Leishmaniasis: treatment updates and clinical practice guidelines review.
AU - Copeland,Nathanial K,
AU - Aronson,Naomi E,
PY - 2015/8/28/entrez
PY - 2015/8/28/pubmed
PY - 2016/2/24/medline
SP - 426
EP - 37
JF - Current opinion in infectious diseases
JO - Curr Opin Infect Dis
VL - 28
IS - 5
N2 - PURPOSE OF REVIEW: This review summarizes recent important and interesting articles investigating the challenging treatment of the parasitic infection, leishmaniasis. In addition, it compares and contrasts leishmaniasis clinical practice treatment guidelines. RECENT FINDINGS: Studies show that, in contrast to experience in India, visceral leishmaniasis in East Africa requires higher doses of liposomal amphotericin for effective treatment results and that pentavalent antimonial drugs remain efficacious. A retrospective study of visceral leishmaniasis in organ transplant patients suggests that there may be a role for secondary prophylaxis after treatment akin to HIV coinfection recommendations. The pros and cons of oral therapy with miltefosine, which cuts across leishmaniasis syndromes in its spectrum, are discussed. Cutaneous leishmaniasis clinical practice guidelines vary, although the recent European guidelines favor species-directed therapy. SUMMARY: Leishmaniasis remains a neglected tropical disease, with a need for additional clinical trials with better design and reported endpoints to lead evidence-based treatment recommendations--especially in cutaneous leishmaniasis and leishmaniasis in the immunocompromised host.
SN - 1473-6527
UR - https://www.unboundmedicine.com/medline/citation/26312442/Leishmaniasis:_treatment_updates_and_clinical_practice_guidelines_review_
L2 - https://doi.org/10.1097/QCO.0000000000000194
DB - PRIME
DP - Unbound Medicine
ER -