From the Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Department of Pediatrics, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India.
Pediatr Infect Dis J. 2018 May;37(5):492-494. doi: 10.1097/INF.0000000000001885.
Visceral leishmaniasis affects 200-400 thousands people annually worldwide. For last few decades, there has been a steady decline in the response to pentavalent antimonial (Sb), the drug that has been used for treating visceral leishmaniasis for almost a century. Oral miltefosine and amphotericin B are alternative drugs being been used in the treatment of leishmaniasis in children. Liposomal amphotericin B has the advantage over conventional amphotericin B is that higher doses can be given with fewer adverse effects. Liposomal amphotericin B in combination with other drugs is the preferred treatment option globally especially in Indian subcontinent. Combination therapy with multiple drugs should undergo larger clinical trials in children as these will shorten the duration of therapy, improve compliance and decrease both toxicity and drug resistance.
内脏利什曼病每年在全球影响 20 万至 40 万人。在过去几十年中,对五价锑(Sb)的反应一直呈稳定下降趋势,这种药物已用于治疗内脏利什曼病近一个世纪。米替福新和两性霉素 B 口服制剂是在儿童中治疗利什曼病的替代药物。脂质体两性霉素 B 优于传统两性霉素 B,因为它可以使用更高剂量而不良反应更少。脂质体两性霉素 B 联合其他药物是全球特别是在印度次大陆的首选治疗方案。联合多种药物的联合治疗应该在儿童中进行更大规模的临床试验,因为这将缩短治疗时间,提高依从性,并降低毒性和耐药性。