title: Leishmaniasis: treatment updates and clinical practice guidelines review.
abstract: OBJECTIVE
  This review summarizes recent important and interesting articles investigating the challenging treatment of the parasitic infection, leishmaniasis. In addition, it compares and contrasts leishmaniasis clinical practice treatment guidelines.
  
  
  RESULTS
  Studies show that, in contrast to experience in India, visceral leishmaniasis in East Africa requires higher doses of liposomal amphotericin for effective treatment results and that pentavalent antimonial drugs remain efficacious. A retrospective study of visceral leishmaniasis in organ transplant patients suggests that there may be a role for secondary prophylaxis after treatment akin to HIV coinfection recommendations. The pros and cons of oral therapy with miltefosine, which cuts across leishmaniasis syndromes in its spectrum, are discussed. Cutaneous leishmaniasis clinical practice guidelines vary, although the recent European guidelines favor species-directed therapy.
  
  
  CONCLUSIONS
  Leishmaniasis remains a neglected tropical disease, with a need for additional clinical trials with better design and reported endpoints to lead evidence-based treatment recommendations--especially in cutaneous leishmaniasis and leishmaniasis in the immunocompromised host.
authors: aWalter Reed National Military Medical Center bUniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors: Nathanial K
authors: NK
authors: Copeland
authors: Naomi E
authors: NE
authors: Aronson
mesh_terms: D006801:Humans; D007891:Leishmania; D007896:Leishmaniasis / Q000628:therapy*; D017410:Practice Guidelines as Topic; D014344:Trypanocidal Agents
chemical_list: D014344:Trypanocidal Agents