Amphotericin B therapy in children with visceral leishmaniasis: daily vs. alternate day, a randomized trial.
A randomized study was carried out to compare the efficacy and adverse reactions of daily vs. alternate day regimens of amphotericin B in children with visceral leishmaniasis (VL). Six hundred and five children of VL below 14 years of age were randomized into two groups; Group A (302), who received amphotericin B at a dose of 1 mg kg(-1) day(-1) for 15 days and Group B (303); same doses but on alternate days. All patients in both groups were cured, who had completed course of amphotericin B therapy. None had relapsed at 1 and 6 months of follow-up. Adverse reactions in both groups were non-significant. The duration of stay and cost of therapy was significantly lower in Group A children who left the hospital against medical advice, which was also significantly more in Group B. Thus, daily regimen of amphotericin B is equally effective, well tolerated, not more toxic and cost-effective than alternate day regimen, which is currently practiced.
Singh
Utpal Kant
UK
Department of Pediatrics and Child Care Center, Nalanda Medical College, Patna 800016, Bihar, India. utpalkant.singh@yahoo.co.in
Prasad
Rajniti
R
Jaiswal
Bir Prakash
BP
Singh
Prabhat Kumar
PK
Thakur
C P
CP
D000293:Adolescent; D000666:Amphotericin B / Q000008:administration & dosage* / Q000191:economics; D000818:Animals; D000981:Antiprotozoal Agents / Q000008:administration & dosage* / Q000191:economics; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007893:Leishmania donovani / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
D000981:Antiprotozoal Agents; D000666:Amphotericin B