Treatment of visceral leishmaniasis with amphotericin B colloidal dispersion

Chemotherapy. 1999 Jun:45 Suppl 1:54-66. doi: 10.1159/000048471.

Abstract

Amphotericin B is an effective antileishmanial agent whose use is limited by drug toxicity. The development of less toxic, lipid encapsulated formulations of amphotericin B as antimycotic agents has made these formulations available for testing against visceral leishmaniasis, a disease ideally suited for 'liposomal' therapy since the parasites are only found within reticuloendothelial macrophages. In phase II experiments of Amphotericin B Colloidal Dispersion (ABCD) for Brazilian kala-azar, 10 of 10 patients were cured with 2 mg/kg/day for 10 days; 9 of 9 patients were cured with 2 mg/kg/day for 7 days; 9 of 10 patients were cured with 2 mg/kg/day for 5 days. The ability to cure 90% of kala-azar patients with a regimen of merely 5 days is remarkable considering that 20-40 days of treatment with pentavalent antimonials and a 28-40 day course of (every-other-day) amphotericin B desoxycholate therapy are otherwise needed. Although ABCD did frequently cause a syndrome of fever and respiratory distress during infusion for children less than 6 years of age, the virtual absence of kidney toxicity was striking.

Publication types

  • Review

MeSH terms

  • Amphotericin B / administration & dosage
  • Amphotericin B / adverse effects
  • Amphotericin B / therapeutic use*
  • Antiprotozoal Agents / administration & dosage
  • Antiprotozoal Agents / adverse effects
  • Antiprotozoal Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Clinical Trials, Phase II as Topic
  • Humans
  • Infant
  • Leishmaniasis, Visceral / drug therapy*
  • Treatment Outcome

Substances

  • Antiprotozoal Agents
  • Amphotericin B