Background: Miltefosine is the first recognized oral treatment for leishmaniasis. It was first registered, in 2002, for Indian visceral leishmaniasis, and was reviewed by the present author in 2005.
Question: Miltefosine is now being used for the full range of clinical leishmaniasis. The present review addresses non-clinical and clinical advances since 2005.
Methods: PubMed was accessed for all articles on miltefosine from 2005 to 2008.
Results/conclusions: Miltefosine is effective and can be recommended for visceral disease in India and in Ethiopia, and for cutaneous disease in Colombia and Bolivia. For unusual forms of disease that require long periods of treatment such as diffuse cutaneous leishmaniasis and post-kala-azar dermal leishmaniasis, oral miltefosine is probably the treatment of choice.