Liposomal amphotericin B treatment of Old World cutaneous and mucosal leishmaniasis: A literature review

Acta Trop. 2018 Jun;182:246-250. doi: 10.1016/j.actatropica.2018.03.016. Epub 2018 Mar 14.

Abstract

Old World cutaneous and mucosal leishmaniasis is a potentially serious disease. Systemic treatment approaches with pentavalent antimonials, liposomal amphotericin B, fluconazole and miltefosine are increasingly used despite the absence of supportive evidence - to date, no prospective clinical trials have been conducted for systemic treatment of these diseases. We performed a literature search to delineate the contemporary evidence for the use of liposomal amphotericin B, and found that although cure rates of 17/20 (85%) were achieved in immune competent patients with Old World cutaneous leishmaniasis and cure rates of 10/13 (77%) for Old World mucosal leishmaniasis due to L. infantum, the available data is highly limited with high variation in total treatment dosages. The presented findings reflect a lack of consensus on the optimal treatment dosage and on the schedule of application.

Keywords: Cutaneous leishmaniasis; Liposomal amphotericin B; Mucosal leishmaniasis; Old World leishmaniasis; Systemic treatment.

Publication types

  • Review

MeSH terms

  • Amphotericin B / therapeutic use*
  • Antiprotozoal Agents / therapeutic use*
  • Humans
  • Leishmaniasis, Mucocutaneous / drug therapy*
  • Treatment Outcome

Substances

  • Antiprotozoal Agents
  • liposomal amphotericin B
  • Amphotericin B