Use of amphotericin B in drug-resistant cases of visceral leishmaniasis in north Bihar, India.
Thirty-four multidrug-resistant cases of Indian visceral leishmaniasis (kala-azar) were treated with amphotericin B. A complete hemogram, liver and renal function tests, determination of serum electrolyte levels, a chest radiograph, and an electrocardiogram were done before, during, and after completion of therapy. Assessment for clinical and parasitologic cure was done weekly. Thirty-one patients who completed treatment had full cure after receiving 10-15 injections at six-months follow up. One patient died of myocarditis. A febrile reaction was observed in all cases, while thrombophlebitis was found in six cases (18.75%). Anorexia, nausea, and vomiting were found in seven cases (21.88%). No significant nephrotoxicity or electrolyte disturbances were observed. It is concluded that amphotericin B is an effective second-line drug for Indian visceral leishmaniasis, but unpredictable drug-induced myocarditis remains a problem.
Jha
T K
TK
Kala-Azar Research Centre, Brahmpura, Muzaffarpur, Bihar, India.
Giri
Y N
YN
Singh
T K
TK
Jha
S
S
D000293:Adolescent; D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D018432:Drug Resistance, Multiple; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000139:chemically induced; D013154:Spleen / Q000469:parasitology / Q000473:pathology
D000666:Amphotericin B