Liposomal Amphotericin B for the Treatment of Visceral Leishmaniasis

During the past decade, liposomal amphotericin B has been used with increasing frequency to treat visceral leishmaniasis (VL). The World Health Organization convened a workshop to review current knowledge and to develop guidelines for liposomal amphotericin B use for VL. In Europe, liposomal amphote...

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Bibliographic Details
Published in:Clinical infectious diseases 2006-10, Vol.43 (7), p.917-924
Main Authors: Saravolatz, Louis D., Bern, Caryn, Adler-Moore, Jill, Berenguer, Juan, Boelaert, Marleen, den Boer, Margriet, Davidson, Robert N., Figueras, Concepcion, Gradoni, Luigi, Kafetzis, Dimitris A., Ritmeijer, Koert, Rosenthal, Eric, Royce, Catherine, Russo, Rosario, Sundar, Shyam, Alvar, Jorge
Format: Article
Language:English
Subjects:
AIDS-Related Opportunistic Infections - prevention & control
Amphotericin B - administration & dosage
Amphotericin B - economics
Amphotericin B - pharmacokinetics
Amphotericin B - therapeutic use
Animals
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antifungal agents
Antiparasitic agents
Antiprotozoal Agents - administration & dosage
Antiprotozoal Agents - pharmacokinetics
Antiprotozoal Agents - therapeutic use
Biological and medical sciences
Clinical trials
Clinical Trials as Topic
Dosage
Drug Carriers
Drug Costs
Drug resistance
Drug therapy
Epidemiology
Health Planning Guidelines
Highly active antiretroviral therapy
Human protozoal diseases
Humans
Infectious diseases
Leishmaniasis
Leishmaniasis, Visceral - drug therapy
Leshmaniasis
Lipids
Liposomes
Medical sciences
Neglected diseases
Parasitic diseases
Pharmacology. Drug treatments
Protozoal diseases
Reviews of Anti-Infective Agents
Treatment Outcome
Tropical medicine
Visceral leishmaniasis
Zoonoses
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Description
Summary:During the past decade, liposomal amphotericin B has been used with increasing frequency to treat visceral leishmaniasis (VL). The World Health Organization convened a workshop to review current knowledge and to develop guidelines for liposomal amphotericin B use for VL. In Europe, liposomal amphotericin B is widely used to treat VL. In Africa and Asia, the VL disease burden is high and drug access is poor; liposomal amphotericin B is available only through preferential pricing for nonprofit groups in East Africa. Clinical trials and experience demonstrate high efficacy and low toxicity for liposomal amphotericin B (total dose, 20 mg/kg) in immunocompetent patients with VL. Combination trials in areas with antileishmanial drug resistance, and treatment and secondary prophylaxis trials in VL-human immunodeficiency virus-coinfected patients, are important to safeguard the current armamentarium and to optimize regimens. The public health community should work to broaden access to preferential liposomal amphotericin B pricing by public sector VL treatment programs.
ISSN:1058-4838
1537-6591
DOI:10.1086/507530