Drug Combinations for Visceral Leishmaniasis

PURPOSE OF REVIEW: Several attempts have been made to combine drugs for treating visceral leishmaniasis, but only recently have effective drugs become available and combinations been tested systematically. RECENT FINDINGS: Sequential treatments with liposomal amphotericin B followed by miltefosine o...

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Main Author:	Olliaro, P. L.
Format:	Journal Article
Language:	EN
Published:	2012
Subjects:	Amphotericin B Antimony Sodium Gluconate Antiprotozoal Agents Cost-Benefit Analysis Drug Resistance Combination Drug Therapy Drug Toxicity Visceral Leishmaniasis Paromomycin Phosphorylcholine use
Online Access:	http://hdl.handle.net/10986/5120

id	okr-10986-5120
recordtype	oai_dc
spelling	okr-10986-51202021-04-23T14:02:21Z Drug Combinations for Visceral Leishmaniasis Olliaro, P. L. Amphotericin B Antimony Sodium Gluconate Antiprotozoal Agents Cost-Benefit Analysis Drug Resistance Combination Drug Therapy Drug Toxicity Visceral Leishmaniasis Paromomycin Phosphorylcholine use PURPOSE OF REVIEW: Several attempts have been made to combine drugs for treating visceral leishmaniasis, but only recently have effective drugs become available and combinations been tested systematically. RECENT FINDINGS: Sequential treatments with liposomal amphotericin B followed by miltefosine or paromomycin (as short as 7 days), as well as the concomitant administration of miltefosine and paromomycin (for 10 days) are very effective in India (>95%). Sodium stibogluconate plus paromomycin for 17 days is more than 90% effective in East Africa. The shortened combination regimens are cost-effective in India. No combination has been tested so far in Brazil, Nepal and Bangladesh, although studies may be expected in the near future. No cost-effectiveness analysis has been done as yet outside India. SUMMARY: There is evidence of high efficacy and benefits with sequential and co-administration treatments in India. More studies are needed in other endemic areas. Introducing combinations and scaling up their use will be challenging. Experience acquired with malaria may be useful. Proper monitoring of use and effects (efficacy and safety) will be required. Currently there are no options for fixed-dose combination treatments for leishmaniasis. 2012-03-30T07:31:24Z 2012-03-30T07:31:24Z 2010 Journal Article Curr Opin Infect Dis 1535-3877 (Electronic) 0951-7375 (Linking) http://hdl.handle.net/10986/5120 EN http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Journal Article
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	EN
topic	Amphotericin B Antimony Sodium Gluconate Antiprotozoal Agents Cost-Benefit Analysis Drug Resistance Combination Drug Therapy Drug Toxicity Visceral Leishmaniasis Paromomycin Phosphorylcholine use
spellingShingle	Amphotericin B Antimony Sodium Gluconate Antiprotozoal Agents Cost-Benefit Analysis Drug Resistance Combination Drug Therapy Drug Toxicity Visceral Leishmaniasis Paromomycin Phosphorylcholine use Olliaro, P. L. Drug Combinations for Visceral Leishmaniasis
relation	http://creativecommons.org/licenses/by-nc-nd/3.0/igo
description	PURPOSE OF REVIEW: Several attempts have been made to combine drugs for treating visceral leishmaniasis, but only recently have effective drugs become available and combinations been tested systematically. RECENT FINDINGS: Sequential treatments with liposomal amphotericin B followed by miltefosine or paromomycin (as short as 7 days), as well as the concomitant administration of miltefosine and paromomycin (for 10 days) are very effective in India (>95%). Sodium stibogluconate plus paromomycin for 17 days is more than 90% effective in East Africa. The shortened combination regimens are cost-effective in India. No combination has been tested so far in Brazil, Nepal and Bangladesh, although studies may be expected in the near future. No cost-effectiveness analysis has been done as yet outside India. SUMMARY: There is evidence of high efficacy and benefits with sequential and co-administration treatments in India. More studies are needed in other endemic areas. Introducing combinations and scaling up their use will be challenging. Experience acquired with malaria may be useful. Proper monitoring of use and effects (efficacy and safety) will be required. Currently there are no options for fixed-dose combination treatments for leishmaniasis.
format	Journal Article
author	Olliaro, P. L.
author_facet	Olliaro, P. L.
author_sort	Olliaro, P. L.
title	Drug Combinations for Visceral Leishmaniasis
title_short	Drug Combinations for Visceral Leishmaniasis
title_full	Drug Combinations for Visceral Leishmaniasis
title_fullStr	Drug Combinations for Visceral Leishmaniasis
title_full_unstemmed	Drug Combinations for Visceral Leishmaniasis
title_sort	drug combinations for visceral leishmaniasis
publishDate	2012
url	http://hdl.handle.net/10986/5120
_version_	1764394020342071296

Drug Combinations for Visceral Leishmaniasis

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