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Amphotericin versus sodium stibogluconate in first-line treatment of Indian kala-azar.
Lancet. 1994 Dec 10; 344(8937):1599-600.Lct

Abstract

Patients do not always respond to treatment of visceral leishmaniasis with pentavalent antimony, and the drug has toxic effects. Amphotericin B might be useful as an alternative first-line treatment for the disease. We compared the efficacy of amphotericin and sodium stibogluconate in a prospective randomised trial in 80 uncomplicated and parasitologically confirmed cases of Indian kala-azar. None of the patients had received an antileishmanial agent before. Sodium stibogluconate was given at 20 mg/kg in two divided doses daily for 40 days, and amphotericin in fourteen doses of 0.5 mg/kg infused in 5% dextrose on alternate days. All 40 patients randomised to amphotericin were cured; of the 40 patients assigned to sodium stibogluconate, 28 (70%) showed initial cure and 25 (62.5%) showed definitive cure (p < 0.001). With amphotericin, there was quicker abatement of fever and more complete spleen regression with no serious adverse effects. Amphotericin is effective in the first-line treatment of Indian kala-azar and superior to antimony therapy.

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Authors+Show Affiliations

Mishra M
Darbhanga Medical College and Hospital, Bihar, India.
Biswas UK
No affiliation info available
Jha AM
No affiliation info available
Khan AB
No affiliation info available

MeSH

AdultAmphotericin BAntimony Sodium GluconateDrug Administration ScheduleFemaleHumansIndiaLeishmaniasis, VisceralMaleTreatment Outcome

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

7983993

Citation

Mishra, M, et al. "Amphotericin Versus Sodium Stibogluconate in First-line Treatment of Indian Kala-azar." Lancet (London, England), vol. 344, no. 8937, 1994, pp. 1599-600.
Mishra M, Biswas UK, Jha AM, et al. Amphotericin versus sodium stibogluconate in first-line treatment of Indian kala-azar. Lancet. 1994;344(8937):1599-600.
Mishra, M., Biswas, U. K., Jha, A. M., & Khan, A. B. (1994). Amphotericin versus sodium stibogluconate in first-line treatment of Indian kala-azar. Lancet (London, England), 344(8937), 1599-600.
Mishra M, et al. Amphotericin Versus Sodium Stibogluconate in First-line Treatment of Indian Kala-azar. Lancet. 1994 Dec 10;344(8937):1599-600. PubMed PMID: 7983993.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Amphotericin versus sodium stibogluconate in first-line treatment of Indian kala-azar. AU - Mishra,M, AU - Biswas,U K, AU - Jha,A M, AU - Khan,A B, PY - 1994/12/10/pubmed PY - 1994/12/10/medline PY - 1994/12/10/entrez SP - 1599 EP - 600 JF - Lancet (London, England) JO - Lancet VL - 344 IS - 8937 N2 - Patients do not always respond to treatment of visceral leishmaniasis with pentavalent antimony, and the drug has toxic effects. Amphotericin B might be useful as an alternative first-line treatment for the disease. We compared the efficacy of amphotericin and sodium stibogluconate in a prospective randomised trial in 80 uncomplicated and parasitologically confirmed cases of Indian kala-azar. None of the patients had received an antileishmanial agent before. Sodium stibogluconate was given at 20 mg/kg in two divided doses daily for 40 days, and amphotericin in fourteen doses of 0.5 mg/kg infused in 5% dextrose on alternate days. All 40 patients randomised to amphotericin were cured; of the 40 patients assigned to sodium stibogluconate, 28 (70%) showed initial cure and 25 (62.5%) showed definitive cure (p < 0.001). With amphotericin, there was quicker abatement of fever and more complete spleen regression with no serious adverse effects. Amphotericin is effective in the first-line treatment of Indian kala-azar and superior to antimony therapy. SN - 0140-6736 UR - https://www.unboundmedicine.com/medline/citation/7983993/Amphotericin_versus_sodium_stibogluconate_in_first_line_treatment_of_Indian_kala_azar_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0140-6736(94)90406-5 DB - PRIME DP - Unbound Medicine ER -