Pharmacokinetics of antimony in children treated for leishmaniasis with meglumine antimoniate

J Infect Dis. 2007 Feb 15;195(4):602-8. doi: 10.1086/510860. Epub 2007 Jan 11.


Background: In some settings, the response to pentavalent antimonial therapy for leishmaniasis may be lower in children than in adults. We hypothesized that there are age-dependent pharmacokinetic differences of potential clinical relevance.

Methods: We compared the pharmacokinetics of antimony (Sb) in adults and 2 groups of children 3-6 years old who had cutaneous leishmaniasis treated with intramuscular meglumine antimoniate. Adults (n=9) and the first group of children (n=9) received 20 mg Sb/kg/day for 20 days; the second group of children (n=6) received 20 mg Sb/kg for 19 days and 30 mg Sb/kg on day 20. Drug exposure was assessed by the area under the 24-h time-concentration curve (AUC(0-24)) in plasma.

Results: Children (vs. adults) who received 20 mg/kg had a 42% lower AUC(0-24) (mean +/- SE, 111+/-7 vs. 190+/-10 mg x h/L, compared with adults; P<.001), a 16% lower peak concentration (32.7+/-0.9 vs. 38.8+/-2.1 mg/L; P=.04), and a 75% higher weight-adjusted clearance (0.185+/-0.013 vs. 0.106+/-0.006 L/h/kg; P<.001). The 30 mg/kg dose in children increased the AUC(0-24) to 164+/-10 mg x h/L and the peak concentration to 43.8+/-2.3 mg/L.

Conclusions: Drug exposure is significantly lower in children than in adults treated with the same weight-adjusted regimen of meglumine antimoniate, which primarily stems from a higher antimony clearance rate.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antimony / pharmacokinetics*
  • Area Under Curve
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Leishmaniasis, Cutaneous / drug therapy*
  • Leishmaniasis, Cutaneous / metabolism
  • Male
  • Meglumine / administration & dosage
  • Meglumine / therapeutic use*
  • Meglumine Antimoniate
  • Metabolic Clearance Rate
  • Organometallic Compounds / administration & dosage
  • Organometallic Compounds / therapeutic use*
  • Plasma / chemistry


  • Organometallic Compounds
  • Meglumine
  • Meglumine Antimoniate
  • Antimony