Safety and efficacy of intravenous sodium stibogluconate in the treatment of leishmaniasis: recent U.S. military experience.
The efficacy and toxicity of sodium stibogluconate (SSG) at a dosage of 20 mg/(kg.d) for either 20 days (for cutaneous disease) or 28 days (for visceral, mucosal, or viscerotropic disease) in the treatment of leishmaniasis is reported. Ninety-six U.S. Department of Defense health care beneficiaries with parasitologically confirmed leishmaniasis were prospectively followed for 1 year. One patient was infected with human immunodeficiency virus; otherwise, comorbidity was absent. Clinical cure occurred in 91% of 83 cases of cutaneous disease and 93% of 13 cases of visceral/viscerotropic disease. Adverse effects were common and necessitated interruption of treatment in 28% of cases, but they were generally reversible. These included arthralgias and myalgias (58%), pancreatitis (97%), transaminitis (67%), headache (22%), hematologic suppression (44%), and rash (9%). No subsequent mucosal leishmaniasis was identified, and there were no deaths attributable to SSG or leishmaniasis.
Aronson
N E
NE
Walter Reed Army Medical Center, Washington, D.C. 20307-5001, USA.
Wortmann
G W
GW
Johnson
S C
SC
Jackson
J E
JE
Gasser
R A
RA
Magill
A J
AJ
Endy
T P
TP
Coyne
P E
PE
Grogl
M
M
Benson
P M
PM
Beard
J S
JS
Tally
J D
JD
Gambel
J M
JM
Kreutzer
R D
RD
Oster
C N
CN
D000293:Adolescent; D000328:Adult; D000967:Antimony Sodium Gluconate / Q000009:adverse effects / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007275:Injections, Intravenous; D007896:Leishmaniasis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D010195:Pancreatitis / Q000139:chemically induced; D016896:Treatment Outcome
D000981:Antiprotozoal Agents; D000967:Antimony Sodium Gluconate