An update on pharmacotherapy for leishmaniasis.

Area of Science:

• Parasitology
• Tropical Medicine
• Pharmacology

Background:

• Leishmaniasis presents as visceral (VL), cutaneous (CL), and mucocutaneous forms.
• Current treatments for leishmaniasis are limited, toxic, and require long durations.
• Drug resistance and toxicity pose significant challenges in leishmaniasis management.

Purpose of the Study:

• To review current treatment strategies for leishmaniasis.
• To identify areas for improvement in leishmaniasis therapy.
• To highlight the need for novel treatment approaches.

Main Methods:

• Literature search conducted on PubMed focusing on leishmaniasis treatment.
• Analysis of treatment regimens for VL and CL in different geographical regions.
• Evaluation of drug combinations and single-dose therapies.

Main Results:

• Single-dose liposomal amphotericin B (L-AmB) and combination therapies are preferred for VL in the Indian subcontinent.
• Specific regimens are recommended for East African VL, Mediterranean, and South American VL.
• CL treatment decisions depend on lesion severity, species, and mucosal involvement risk.

Conclusions:

• Urgent implementation of single-dose L-AmB or combination therapy is needed for the Indian subcontinent.
• Shorter, more acceptable regimens are required for post-kala-azar dermal leishmaniasis.
• Combination therapy with new drugs requires testing in Africa; local treatment is preferred for New World CL without mucosal risk.