[First-line liposomal amphotericin B for pediatric visceral leishmaniasis in southern France].
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.
Minodier
P
P
Urgences pédiatriques, CHU Nord, chemin des Bourrelly, Marseille, France. laporte-turpin.e@chu-toulouse.fr
Robert
S
S
Noël
G
G
Blanc
P
P
Retornaz
K
K
Garnier
J M
JM
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
D000981:Antiprotozoal Agents; D008081:Liposomes; D000666:Amphotericin B