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Cutaneous Leishmaniasis in the Dorsal Skin of Hamsters: a Useful Model for the Screening of Antileishmanial Drugs
Published on: April 21, 2012
Treatment of pediatric cutaneous leishmaniasis with liposomal amphotericin B
Tugba Erat1, Isa An2
1Department of Pediatric Infectious Diseases, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey.
Insights
Liposomal amphotericin B (L-AmB) showed low efficacy in treating pediatric cutaneous leishmaniasis (CL), with a 69% failure rate. Higher doses and pathogen identification are needed for effective pediatric CL treatment.
Area of Science:
- Infectious Diseases
- Dermatology
- Pediatrics
Background:
- Liposomal amphotericin B (L-AmB) use is rising for cutaneous leishmaniasis (CL).
- Limited data exist on L-AmB efficacy and safety in pediatric CL cases.
Purpose of the Study:
- To assess the efficacy and safety of L-AmB in pediatric CL patients.
- To evaluate L-AmB treatment outcomes in a hyperendemic CL region.
Main Methods:
- Retrospective study of 52 pediatric CL patients receiving L-AmB.
- Standard L-AmB dosage: 3 mg/kg for 5 days, then on day 10 (18 mg/kg total).
- Follow-up conducted 3 months post-treatment.
Main Results:
- Complete clinical recovery observed in 31% (16/52) of patients.
- Treatment failure occurred in 69% (36/52) of pediatric patients.
- Low efficacy suggests current L-AmB dosage may be inadequate for pediatric CL.
Conclusions:
- The L-AmB dosage used in this study demonstrated a low treatment success rate in pediatric CL.
- Further prospective studies with higher L-AmB doses and pathogen identification are recommended.
- Current L-AmB regimen is not considered appropriate for pediatric CL treatment based on these findings.
Abstract:
The use of liposomal amphotericin B (L-AmB) in the treatment of cutaneous leishmaniasis (CL) is increasing. However, few data are available regarding the efficacy and safety of L-AmB in pediatric CL patients. Our aim in this study is to evaluate the efficacy and safety of L-AmB in pediatric CL patients. Pediatric patients admitted to a tertiary training and research hospital in a hyperendemic region for CL between January 2019 and May 2021 and receiving L-AmB therapy for CL were included in this retrospective study. L-AmB treatment was administered as 3 mg/kg for 5 consecutive days and on the 10th day, in a total of 6 doses (18 mg/kg total dose). A total of 52 pediatric patients who received L-AmB therapy for CL were included in the study. In the follow-up 3 months after L-AmB treatment, 16 (31%) patients showed complete clinical recovery, while treatment failure was detected in 36 (69%) patients. In conclusion, considering the low treatment success rate in our study, we think that the L-AmB dose used in our study is not an appropriate treatment option for the treatment of pediatric CL patients. However, we think that prospective studies with a large number of patients treated with higher doses of L-AmB and in whom the causative agents of CL were determined are needed.
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