[Short course treatment for visceral leishmaniasis with liposomal amphotericin B in immunocompetent patients].
BACKGROUND
Visceral leishmaniasis is endemic in southern Europe. Traditional treatment consists of pentavalent antimonial compounds. However, treatment failures, the treatment's long duration, and toxicity have led to the introduction of new therapies, such as liposomal amphotericin B (LAB). In this study we evaluate the safety and efficacy of LAB at a maximum dose of 4 mg/kg/day on days 1, 2, 3, 4, 5, and 10.


METHODS
A prospective, observational, open study was conducted in 13 Spanish centers. The diagnosis of visceral leishmaniasis was based on visualization of Leishmanias sp. in bone marrow aspirate or culture or positive serology together with compatible clinical symptoms.


RESULTS
Thirty-two immunocompetent children aged from 7 months to 7 years were treated. All the children had rapid clinical response and bone marrow aspirate performed on day 21 was normal in the 24 patients (100 %) who underwent this procedure. In the remaining eight children efficacy was assessed by clinical response. Two relapses were observed. Cure was achieved in 18 patients (90.0 %) and in 87.5 % of the patients with microbiological confirmation of the disease. No adverse events were detected.


CONCLUSIONS
A total dosage of 24 mg/kg of liposomal amphotericin B administered in 6 doses within 10 days is safe and effective for the treatment of visceral leishmaniasis and reduces the length of hospital stay.
Figueras Nadal
M C
MC
Unidad de Enfermedades Infecciosas. Hospital Infantil Vall D'Hebron. Barcelona. Spain.
García de Miguel
M J
MJ
Asensi Botet
F
F
Velasco Bernardo
R
R
Canals Baeza
A
A
Ausín Aoiz
I
I
D000666:Amphotericin B / Q000008:administration & dosage*; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D008081:Liposomes; D008297:Male; D011446:Prospective Studies; D013030:Spain
D000981:Antiprotozoal Agents; D008081:Liposomes; D000666:Amphotericin B