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[Treatment of visceral leishmaniasis in children]

P Minodier1, G Noël, P Blanc

  • 1Urgences Pédiatrique, CHU Nord, Marseille, France. philippe.minodier@ap-hm.fr

Medecine Tropicale : Revue Du Corps De Sante Colonial
|May 18, 2007
PubMed

Insights

Liposomal amphotericin B is now the preferred treatment for pediatric visceral leishmaniasis in France due to its high efficacy and tolerability. Shorter treatment protocols are under investigation to reduce costs.

Area of Science:

  • Infectious Diseases
  • Parasitology
  • Pharmacology

Background:

  • Visceral leishmaniasis caused by Leishmania infantum is endemic in Southern France.
  • Pentavalent antimonials (meglumine antimoniate, sodium stibogluconate) were traditional treatments but have issues with tolerability and emerging resistance.
  • Liposomal amphotericin B is now the recommended alternative for treating children.

Purpose of the Study:

  • To review the current treatment landscape for pediatric visceral leishmaniasis in France.
  • To highlight the efficacy and tolerability of liposomal amphotericin B.
  • To discuss potential new treatment strategies.

Main Methods:

  • Review of current clinical practices and treatment guidelines for visceral leishmaniasis in France.
  • Analysis of efficacy and safety data for liposomal amphotericin B.
  • Consideration of emerging treatment options like miltefosine.

Main Results:

  • Liposomal amphotericin B demonstrates high efficacy (nearly 100%) and good tolerability in children.
  • Standard treatment involves six intravenous injections, but a shorter two-day protocol is being studied to reduce hospitalization costs.
  • Miltefosine, an oral drug effective in India, has not yet been evaluated for Mediterranean visceral leishmaniasis.

Conclusions:

  • Liposomal amphotericin B is the current standard of care for pediatric visceral leishmaniasis in France, offering significant advantages over older antimonial drugs.
  • Further research into cost-effective treatment durations, such as the two-day protocol, is warranted.
  • The efficacy of oral miltefosine for Mediterranean strains of visceral leishmaniasis requires investigation.

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