Durand R, Paul M, Pratlong F, Rivollet D, Dubreuil-Lemaire M L, Houin R, Astier A, Deniau M
Laboratoire de Parasitologie, CHU Henri Mondor, 94010 Créteil, France.
Antimicrob Agents Chemother. 1998 Aug;42(8):2141-3. doi: 10.1128/AAC.42.8.2141.
Amphotericin B (AmB) has been used as a second-line treatment of visceral leishmaniasis, particularly in human immunodeficiency virus-positive patients. AmB median effective doses (ED50s) were determined on an isolate obtained before any treatment and on a second isolate obtained 4 years later from the same AmB-treated patient. ED50s were similar (0.059 and 0.067 mg/kg of body weight, respectively), demonstrating the first evidence of AmB ED50 stability of Leishmania infantum after a long-term drug exposure. An isoenzymatic study was performed in order to verify that the second isolate originated from the same parasite as the first isolate. The present case report showed that treatment failure was not due to parasite resistance in spite of a prolonged exposure to the drug.
两性霉素B（AmB）一直被用作内脏利什曼病的二线治疗药物，尤其是在人类免疫缺陷病毒阳性患者中。对在任何治疗之前获得的一个分离株以及4年后从同一位接受AmB治疗的患者身上获得的第二个分离株测定了AmB的半数有效剂量（ED50）。ED50相似（分别为0.059和0.067mg/kg体重），这首次证明了婴儿利什曼原虫在长期药物暴露后AmB ED50的稳定性。进行了一项同工酶研究，以验证第二个分离株与第一个分离株源自同一寄生虫。本病例报告表明，尽管长期接触该药物，但治疗失败并非由于寄生虫耐药。
