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AFRO-NETS> RFI: Treatment of Leishmaniasis (2)
RFI: Treatment of Leishmaniasis (2)
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Dear Dr. M. Mbeseni,
MSF in their 3rd ed (1993) Clinical Guidelines, p. 138, recommends
following Rx:
Antimony drugs:
meglumine antimonate (amp 5 ml=1.5 g in IM); 50 mg/kg/dx10 to 15 days
sodium stibogluconate (amp. 1 ml=100 mg in IM or IV)
Adult: 6 ml/d
Child under 5 years: 2 ml/d
Child 5-15 years: 4 ml/d
Duration of RX 30 days, except Indian Kalazar for which duration of
Rx is 6 days.
Observe for chills fever, cough, rash, myalgia, polyneuritis, cardiac
failure, and renal failure.
We used Stibitine brand of sodium stibogluconate in Bangladesh for
Kalazar with success. Nasty side effects, though.
Pentamidine (amp. 3 ml=120 mg in IM) 2 to 4 mg/kg x 6 injections
every 48 hours -- observe carefully for hypoglycaemia or hyperglycae-
mia.
American Public Health Assn, Control of Communicable Disease Manual,
17th ed, 2000, p. 289 recommends: Sodium stibogluconate and meglumine
antimonite -- no dose given. For cases who do not respond use ampho-
tericin B or pentamidine -- observe closely for toxicity. They note
that "In some regions, such as Kenya and India, the disease is less
responsive to treatment than in Mediterranean countries and may re-
quire longer courses of therapy then are typically used."
You may be able to get more information from CDC Atlanta:
http://www.cdc.gov
Good luck,
Sarah Archer, RN, DrPH
mailto:[email protected]
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