What is the role of antibiotics in the treatment of leishmaniasis?

Updated: Feb 18, 2020
  • Author: Craig G Stark, MD, FACP, FFTM, RCPS(Glasg), FISTM; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Patients with leishmaniasis may have concurrent systemic illness or local infection. Visceral leishmaniasis is an important opportunistic infection associated with acquired immunodeficiency syndrome (AIDS), and patients co-infected with human immunodeficiency virus (HIV) can develop unusual manifestations of leishmaniasis. Guidelines for prevention and treatment of opportunistic diseases in patients with HIV infection have been established. [27, 28]

Pentamidine is a first-line medication in cutaneous leishmaniasis except for L mexicana (ketoconazole 600 mg PO qd for 28 days). It is a treatment alternative in visceral leishmaniasis. Available antibiotic preparations include pentamidine isethionate (Pentam) and pentamidine dimethanesulfonate (Lomidine). Pentamidine dimethane sulphonate administered in the same dose schedule is more effective than pentamidine isethionate.


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