Amphotericin B Treatment for Indian Visceral Leishmaniasis: Conventional versus Lipid Formulations Academic Article uri icon

Overview

MeSH Major

  • Amphotericin B
  • Antiprotozoal Agents
  • Deoxycholic Acid
  • Leishmaniasis, Visceral
  • Phosphatidylcholines
  • Phosphatidylglycerols

abstract

  • In Bihar, India, where visceral leishmaniasis is hyperendemic, amphotericin B deoxycholate is now first-line parenteral treatment. To test the efficacy of amphotericin B deoxycholate versus that of its lipid formulations, Indian patients were randomized to receive treatment with amphotericin B deoxycholate (1 mg/kg on alternate days for 30 days; n=51), liposomal amphotericin B (2 mg/kg per day for 5 days; n=51), or amphotericin B lipid complex (2 mg/kg per day for 5 days; n=51). Infusion-associated reactions were frequent and persistent in subjects treated with amphotericin B deoxycholate. The illness of 3 patients failed to respond to treatment, and 5 patients experienced relapse. Final cure rates were similar. Estimated total treatment costs for a 25-kg patient-417 dollars for amphotericin B deoxycholate, 872 dollars for liposomal amphotericin B, and 947 dollars for amphotericin B lipid complex-differed as a result of drug cost. Substantial reductions (approximately 60%) in the price of liposomal amphotericin B and amphotericin B lipid complex would make treatment costs comparable to that of amphotericin B deoxycholate, permitting administration of short-course regimens in India.

publication date

  • February 2004

Research

keywords

  • Academic Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1086/380971

PubMed ID

  • 14727208

Additional Document Info

start page

  • 377

end page

  • 83

volume

  • 38

number

  • 3