Drug combinations for visceral leishmaniasis
- PMID: 20871400
- DOI: 10.1097/QCO.0b013e32833fca9d
Drug combinations for visceral leishmaniasis
Abstract
Purpose of review: Several attempts have been made to combine drugs for treating visceral leishmaniasis, but only recently have effective drugs become available and combinations been tested systematically.
Recent findings: Sequential treatments with liposomal amphotericin B followed by miltefosine or paromomycin (as short as 7 days), as well as the concomitant administration of miltefosine and paromomycin (for 10 days) are very effective in India (>95%). Sodium stibogluconate plus paromomycin for 17 days is more than 90% effective in East Africa. The shortened combination regimens are cost-effective in India. No combination has been tested so far in Brazil, Nepal and Bangladesh, although studies may be expected in the near future. No cost-effectiveness analysis has been done as yet outside India.
Summary: There is evidence of high efficacy and benefits with sequential and co-administration treatments in India. More studies are needed in other endemic areas. Introducing combinations and scaling up their use will be challenging. Experience acquired with malaria may be useful. Proper monitoring of use and effects (efficacy and safety) will be required. Currently there are no options for fixed-dose combination treatments for leishmaniasis.
Similar articles
-
Drug policy for visceral leishmaniasis: a cost-effectiveness analysis.Trop Med Int Health. 2007 Feb;12(2):274-83. doi: 10.1111/j.1365-3156.2006.01782.x. Trop Med Int Health. 2007. PMID: 17300636
-
Treatment of visceral leishmaniasis in 2010: direction from Bihar State, India.Future Microbiol. 2010 Sep;5(9):1301-3. doi: 10.2217/fmb.10.92. Future Microbiol. 2010. PMID: 20860475 No abstract available.
-
Cost-effectiveness projections of single and combination therapies for visceral leishmaniasis in Bihar, India.Trop Med Int Health. 2009 Aug;14(8):918-25. doi: 10.1111/j.1365-3156.2009.02306.x. Epub 2009 Jun 28. Trop Med Int Health. 2009. PMID: 19563434
-
Progress in the treatment of a neglected infectious disease: visceral leishmaniasis.Expert Rev Anti Infect Ther. 2004 Apr;2(2):279-92. doi: 10.1586/14787210.2.2.279. Expert Rev Anti Infect Ther. 2004. PMID: 15482193 Review.
-
Leishmaniasis: an update of current pharmacotherapy.Expert Opin Pharmacother. 2013 Jan;14(1):53-63. doi: 10.1517/14656566.2013.755515. Epub 2012 Dec 21. Expert Opin Pharmacother. 2013. PMID: 23256501 Review.
Cited by
-
Nitazoxanide and quercetin co-loaded nanotransfersomal gel for topical treatment of cutaneous leishmaniasis with macrophage targeting and enhanced anti-leishmanial effect.Heliyon. 2023 Nov 2;9(11):e21939. doi: 10.1016/j.heliyon.2023.e21939. eCollection 2023 Nov. Heliyon. 2023. PMID: 38027656 Free PMC article.
-
Antileishmanial Efficacy of the Calpain Inhibitor MDL28170 in Combination with Amphotericin B.Trop Med Infect Dis. 2022 Feb 16;7(2):29. doi: 10.3390/tropicalmed7020029. Trop Med Infect Dis. 2022. PMID: 35202224 Free PMC article.
-
Long non-coding RNAs as possible therapeutic targets in protozoa, and in Schistosoma and other helminths.Parasitol Res. 2022 Apr;121(4):1091-1115. doi: 10.1007/s00436-021-07384-5. Epub 2021 Dec 3. Parasitol Res. 2022. PMID: 34859292 Review.
-
Ethanolic Extract of the Fungus Trichoderma asperelloides Induces Ultrastructural Effects and Death on Leishmania amazonensis.Front Cell Infect Microbiol. 2020 Jul 15;10:306. doi: 10.3389/fcimb.2020.00306. eCollection 2020. Front Cell Infect Microbiol. 2020. PMID: 32760675 Free PMC article.
-
In vitro effectivity of three approved drugs and their synergistic interaction against Leishmania infantum.Biomedica. 2020 May 1;40(Supl. 1):89-101. doi: 10.7705/biomedica.4891. Biomedica. 2020. PMID: 32463611 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Research Materials