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Amphotericin B in resistant kala-azar in Bihar
C P Thakur1, G P Sinha, A K Pandey
1Patna Medical College and Hospital, Bihar, India.
The National Medical Journal of India
|March 1, 1993
Summary
Amphotericin B effectively treats kala-azar in patients resistant to standard drugs, achieving a 99% cure rate. Close medical supervision is crucial due to potential side effects.
Area of Science:
- Tropical Medicine
- Infectious Diseases
- Pharmacology
Background:
- Kala-azar epidemic in Bihar identified drug-resistant cases.
- Standard treatments (sodium stibogluconate, pentamidine) were ineffective.
- Amphotericin B is a WHO-recommended second-line drug with proven efficacy.
Purpose of the Study:
- To evaluate the efficacy and safety of amphotericin B.
- To treat patients with kala-azar unresponsive to conventional therapies.
- To assess treatment outcomes and patient response.
Main Methods:
- 300 kala-azar patients unresponsive to standard drugs were selected.
- Amphotericin B administered at 1 mg/kg on alternate days, escalating to 1 mg/kg.
- Comprehensive pre- and post-treatment investigations monitored efficacy and safety.
Main Results:
- 99% cure rate (298/300) with amphotericin B treatment.
- Most patients required 1g (89%), with some needing 1.5g (8%) or 2g (2%).
- Common side effects included fever and shivering; severe events (cardiac arrest) were rare.
Conclusions:
- Amphotericin B is highly effective for drug-resistant kala-azar.
- Treatment requires careful medical supervision due to potential adverse events.
- This study supports amphotericin B as a vital therapeutic option.