A 6 day course of liposomal amphotericin B in the treatment of infantile visceral leishmaniasis: the Italian experience.
OBJECTIVE
To evaluate in a retrospective analysis the efficacy and safety of a 6 day course of liposomal amphotericin B (L-AmB) in infantile cases of Mediterranean visceral leishmaniasis (VL) diagnosed over a 10 year period in Italy.


METHODS
Patients included were diagnosed as having VL consecutively admitted from December 1992 to December 2001 at four main referral children's hospitals in Italy and treated with six intravenous doses of 3 mg/kg L-AmB given on days 1-5 and 10 (a total dose of 18 mg/kg). Demographic data, nutritional status, underlying diseases, clinical and laboratory findings, and therapy outcome were considered.


RESULTS
A total of 164 HIV-negative children (median age 1.6 years; range 4 months to 14 years) were enrolled. All patients were initially cured by the given treatment, and did not present adverse events related to drug infusion. Seven patients (4.3%) had a clinical and parasitological relapse 3-15 months after therapy. All relapses were successfully retreated with 3 mg/kg L-AmB for 10 consecutive days (a total dose of 30 mg/kg).


CONCLUSIONS
This study highlights the efficacy (>95%) and safety of the six dose L-AmB regimen and validates it as a first-line treatment for Mediterranean VL in children.
Cascio
Antonio
A
Clinica Malattie Infettive, Università di Messina, Messina, Italy. acascio@unime.it
di Martino
Lucio
L
Occorsio
Paolo
P
Giacchino
Raffaella
R
Catania
Salvatore
S
Gigliotti
Anna Rita
AR
Aiassa
Camilla
C
Iaria
Chiara
C
Giordano
Salvatore
S
Colomba
Claudia
C
Polara
Valentina Frasca
VF
Titone
Lucina
L
Gradoni
Luigi
L
Gramiccia
Marina
M
Antinori
Spinello
S
D000293:Adolescent; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001853:Bone Marrow / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D004337:Drug Carriers; D005260:Female; D005334:Fever / Q000209:etiology; D005455:Fluorescent Antibody Technique; D006801:Humans; D007223:Infant; D007558:Italy; D007898:Leishmaniasis, Visceral / Q000188:drug therapy* / Q000469:parasitology; D008081:Liposomes; D008297:Male; D009752:Nutritional Status; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
D000981:Antiprotozoal Agents; D004337:Drug Carriers; D008081:Liposomes; D000666:Amphotericin B