RESUMO
We used liposomal amphotericin B as first-choice treatment of visceral leishmaniasis in 106 immunocompetent children who acquired the infection in a temperate region of southern Europe (Italy) where Leishmania infantum visceral leishmaniasis is endemic. The aim of the study was to identify the minimum total dose of liposomal amphotericin B needed to cure the infection in children and reduce the period of hospitalization. We conclude that the optimal regimen in immunocompetent children with L. infantum visceral leishmaniasis to be a total dose of 18 mg/kg of liposomal amphotericin B (3 mg/kg per day for 5 days, followed by 3 mg/kg administered as an outpatient regimen on day 10).
Assuntos
Anfotericina B/administração & dosagem , Antiprotozoários/administração & dosagem , Leishmaniose Visceral/tratamento farmacológico , Adolescente , Assistência Ambulatorial , Animais , Medula Óssea/parasitologia , Criança , Pré-Escolar , Esquema de Medicação , Portadores de Fármacos , Eletroforese , Doenças Endêmicas , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Seguimentos , Hospitalização , Humanos , Imunocompetência , Lactente , Isoenzimas/análise , Itália , Leishmania infantum/efeitos dos fármacos , Leishmania infantum/enzimologia , Tempo de Internação , Lipossomos , MasculinoRESUMO
Thirteen dogs naturally infected with Leishmania infantum showing viscerocutaneous signs of disease were treated with different dosages of liposomal amphotericin B (AmBisome) 3-3.3 kg showed rapid clinical improvement, with regression of lymphadenomegaly and splenomegaly, and cure of skin lesions. The clinical response was similar to that obtained with 14-21 doses of conventional antileishmanial drugs. However, follow-up lymph node aspirates remained positive for Leishmania in all dogs except one, which was treated with the total dose ofAmBisome 15 mg kg. The failure in parasitological cure may be due to inadequate drug targeting to parasitized cells, or to T-cell immune depression characteristic of patent cases of canine leishmaniasis, or to both