title: [First-line liposomal amphotericin B for pediatric visceral leishmaniasis in southern France].
abstract: OBJECTIVE
  First, to describe liposomal amphotericin B (AmBisome use as first line treatment of pediatric visceral leishmaniasis and secondly, to evaluate the incidence of the disease in southern France (Provence - Alpes - Côte d'Azur - Corse).
  
  
  METHODS
  Retrospective chart review of children referred for visceral leishmaniasis from 1996 to 2003.
  
  
  RESULTS
  Thirty-two children under 15 years of age and suffering from visceral leishmaniasis were treated with liposomal amphotericin B as first line treatment. Clinical and biological features were usual: age <5 years, no immunodeficiency, spleen enlargement and fever, cytopenia. In this population, treatment effectiveness was evaluated to 97% (one relapse). Under treatment, patients quickly improved. Drug regimens varied from 18 to 24 mg/kg (day 1 to 5, and day 10). Four other children were not treated with first-line liposomal amphotericin B during the period. Thus, the incidence of pediatric visceral leishmaniasis was evaluated to be 0.61/100,000 children <15 years/year in the region (2.74 in the Alpes-Maritimes department, French Riviera, and 0.6 in the Bouches-du-Rhône department, Marseilles area).
  
  
  CONCLUSIONS
  Liposomal amphotericin B treatment is usual for children referred for visceral leishmaniasis in this region. This treatment may be approved regarding the high level of effectiveness and the low number of adverse events. A two days drug regimen with 20 mg/kg should be evaluated. Moreover, the incidence of the pediatric visceral leishmaniasis in southern France is decreasing, but local variations may be observed.
authors.affiliation: Urgences pédiatriques, CHU Nord, chemin des Bourrelly, Marseille, France. laporte-turpin.e@chu-toulouse.fr
authors.forename: P
authors.initials: P
authors.lastname: Minodier
authors.forename: S
authors.initials: S
authors.lastname: Robert
authors.forename: G
authors.initials: G
authors.lastname: Noël
authors.forename: P
authors.initials: P
authors.lastname: Blanc
authors.forename: K
authors.initials: K
authors.lastname: Retornaz
authors.forename: J M
authors.initials: JM
authors.lastname: Garnier
mesh_terms: D000293:Adolescent; D000666:Amphotericin B / Q000008:administration & dosage*; D000818:Animals; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007898:Leishmaniasis, Visceral / Q000188:drug therapy* / Q000453:epidemiology; D008081:Liposomes; D008297:Male; D008499:Medical Records; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000981:Antiprotozoal Agents; D008081:Liposomes; D000666:Amphotericin B