[Treatment of infantile visceral leishmaniasis].
Visceral leishmaniasis is an endemic disease in the Mediterranean Basin. Children are one of the targets of the infection. Treatment usually requires parenteral injections of pentavalent antimony (Glucantime or Pentostam), but the high frequency of adverse events and the occurrence of primary or secondary resistance cases limit the use of these medications. Diamidines (Pentacarinat) or amphotericin B derivatives are alternatives to antimony. Unfortunately, pharmacokinetics and optimal dosage of diamidines are not well-known, and numerous adverse events are described. Liposomal preparations of amphotericin B enhance its efficiency and tolerance, and the duration of treatment may be reduced to 5 days. Moreover, primary resistance to amphotericin B is not described in immunocompetent children. Allopurinol associated with antimony seems no more efficient than antimony alone. Aminosidine is not evaluated.
Minodier
P
P
Service de pédiatrie, CHU Nord, Marseille, France.
Faraut-Gambarelli
F
F
Piarroux
R
R
Gire
C
C
Garnier
J M
JM
Dumon
H
H
D000666:Amphotericin B / Q000627:therapeutic use; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000737:chemistry / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002648:Child; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome