What is the role of liposomal amphotericin B 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

Amphotericin B in its liposomal form (as opposed to amphotericin B deoxycholate) is now considered to be the drug of choice for visceral leishmaniasis because of its shorter course and lower toxicity. This agent is not approved for the cutaneous or mucosal forms of the disease. [2]

Cost issues prevent the use of liposomal drugs in most countries, where the mainstay of treatment is still prolonged intravenous treatment with antimonial agents, despite ever-increasing patterns of resistance and an increasing incidence of treatment failures. Alternative treatments, such as amphotericin B, should be used when resistance is endemic or when other reasons for using an alternative parenteral exist (eg, lower toxicity profile).


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