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Related Experiment Videos

Current treatment approaches to leishmaniasis.

Jonathan Berman1

  • 1Office of Clinical and Regulatory Affairs, National Center For Complementary and Alternative Medicine, National Institutes of Health, 6707 Democracy Boulevard, Suite 401 Bethesda, MD 20892, USA. Bermanjo@mail.nih.gov

Current Opinion in Infectious Diseases
|September 23, 2003
PubMed
Summary

New treatments for leishmaniasis show promise. Liposomal amphotericin B and miltefosine are highly effective for visceral leishmaniasis, while fluconazole aids cutaneous leishmaniasis treatment.

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Area of Science:

  • Tropical medicine
  • Infectious diseases
  • Parasitology

Background:

  • Leishmaniases present as cutaneous, mucosal, and visceral syndromes.
  • Pentavalent antimonials are the classic treatment but have significant drawbacks including daily injections, toxicity, and emerging resistance.
  • Amphotericin B is an alternative but also requires parenteral administration and carries toxicity risks.

Purpose of the Study:

  • To review clinical investigations of leishmaniasis treatment agents from January 2000 to January 2003.
  • To identify new and effective therapeutic options for leishmaniasis.

Main Methods:

  • Review of clinical investigation studies on leishmaniasis treatment agents.
  • Analysis of pilot studies focusing on visceral and cutaneous leishmaniasis.

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  • Evaluation of treatment efficacy and tolerability.

    • Main Results:

    • Liposomal amphotericin B demonstrates high efficacy (nearly 100% at 15 mg/kg, 90% at 5-10 mg/kg) for Indian visceral leishmaniasis with infrequent administration and good tolerability.
    • The oral agent miltefosine shows over 95% efficacy for Indian visceral leishmaniasis.
    • Fluconazole treatment (6 weeks) accelerates the cure rate for cutaneous leishmaniasis caused by Leishmania major.

    Conclusions:

    • Liposomal amphotericin B and miltefosine represent significant advancements in treating visceral leishmaniasis, offering improved efficacy and administration profiles.
    • Fluconazole provides a beneficial adjunctive therapy for cutaneous leishmaniasis.
    • These newer agents address limitations of traditional treatments, offering better patient outcomes and potentially overcoming resistance issues.