Recent advances in the treatment of visceral leishmaniasis.

摘要: Pentavalent antimonials (sodium stibogluconate and meglumine antimoniate) There is increasing resistance to pentavalent (Sb”) in many countries. Pre-treatment isolates of Leishmania donovani vary considerably their sensitivity Sb” may be induced by prior inadequate courses (GROGL et al., 1989,1992). The World Health Organization (WHO) guidelines (WHO, 1990) reflect the unresponsiveness Sb”, 20 mg Sb”/kg/d for 220 d recommended. In India primary occurs about 10% cases a regimen 240 recommended (THAKUR 1988). HERWALDT & BERMAN (1992) that traditional daily maximum 850 abandoned, as toxicity have been over-emphasized past. rapid urinary elimination sodium (REES 1980) means more effective if given frequently than once (BRYCESON, 1987). ZIJLSTRA al. (1991) showed 10 mgikg every 12 h 15 was better mgikgld 30 d, both CHULAY (1983) GACHIHI (1992a) SbV/kg 8 mgikgid 30d. mechanism clinical antimony has not established, though studies vitro suggest presence P-glycoprotein resistant parasites, which could reversed experimentally verapamil (NEAL 1989). However, humans had no effect reversing resistance, nor improving response rate previously untreated VL KUMAR. 1992). choice between and’ antimoniate treatment determined regional availability cost drugs; there published comparative study. Experimental shown significant differences (NEAL, is, however, known variation potency manufactured lots.