Infectious Diseases Service, Walter Reed Army Medical Center, Washington, District of Columbia 20307, USA.
Am J Trop Med Hyg. 2010 Nov;83(5):1028-33. doi: 10.4269/ajtmh.2010.10-0171.
Treatment options for cutaneous leishmaniasis in the United States are problematic because the available products are either investigational, toxic, and/or of questionable effectiveness. A retrospective review of patients receiving liposomal amphotericin B through the Walter Reed Army Medical Center for the treatment of cutaneous leishmaniasis during 2007-2009 was conducted. Twenty patients who acquired disease in five countries and with five different strains of Leishmania were treated, of whom 19 received a full course of treatment. Sixteen (84%) of 19 experienced a cure with the initial treatment regimen. Three patients did not fully heal after an initial treatment course, but were cured with additional dosing. Acute infusion-related reactions occurred in 25% and mild renal toxicity occurred in 45% of patients. Although the optimum dosing regimen is undefined and the cost and toxicity may limit widespread use, liposomal amphotericin B is a viable treatment alternative for cutaneous leishmaniasis.
美国治疗皮肤利什曼病的选择方案存在问题，因为现有的产品要么处于研究阶段，要么毒性大，要么疗效值得怀疑。对 2007-2009 年期间通过沃尔特里德陆军医疗中心接受脂质体两性霉素 B 治疗皮肤利什曼病的患者进行了回顾性研究。共治疗了来自五个国家、五种不同利什曼原虫株感染的 20 名患者，其中 19 名接受了完整疗程的治疗。19 名患者中 16 名（84%）在初始治疗方案后痊愈。3 名患者在初始疗程后未完全愈合，但经额外剂量治疗后痊愈。25%的患者出现急性输液相关反应，45%的患者出现轻度肾毒性。虽然最佳剂量方案尚未确定，且成本和毒性可能限制其广泛应用，但脂质体两性霉素 B 是治疗皮肤利什曼病的一种可行替代方案。
