Lipsosomal Amphotericin B for Treatment of Cutaneous Leishmaniasis

• Published in: The American journal of tropical medicine and hygiene Vol. 83; no. 5; pp. 1028 - 1033
• Main Authors: WORTMANN, Glenn, ZAPOR, Michael, RESSNER, Roseanne, FRASER, Susan, HARTZELL, Josh, PIERSON, Joseph, WEINTROB, Amy, MAGILL, Alan
• Format: Journal Article
• Language: English
• Published: Deerfield, IL American Society of Tropical Medecine and Hygiene 01.11.2010; The American Society of Tropical Medicine and Hygiene
• Subjects: Adult; Amphotericin B - administration & dosage; Amphotericin B - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; Antiparasitic agents; Antiprotozoal Agents - administration & dosage; Antiprotozoal Agents - therapeutic use; Biological and medical sciences; Female; Human protozoal diseases; Humans; Infectious diseases; Leishmaniasis, Cutaneous - drug therapy; Leshmaniasis; Liposomes; Male; Medical sciences; Middle Aged; Parasitic diseases; Pharmacology. Drug treatments; Protozoal diseases; Retrospective Studies; Treatment Outcome; Young Adult; Infection; Cutaneous leishmaniasis; Antiprotozoal agent; Skin disease; Protozoal disease; Antibiotic; Antifungal agent; Treatment; Amphotericin B; Parasiticide; Tropical medicine; Parasitosis
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.2010.10-0171

Treatment options for cutaneous leishmaniasis in the United States are problematic because the available products are either investigational, toxic, and/or of questionable effectiveness. A retrospective review of patients receiving liposomal amphotericin B through the Walter Reed Army Medical Center for the treatment of cutaneous leishmaniasis during 2007-2009 was conducted. Twenty patients who acquired disease in five countries and with five different strains of Leishmania were treated, of whom 19 received a full course of treatment. Sixteen (84%) of 19 experienced a cure with the initial treatment regimen. Three patients did not fully heal after an initial treatment course, but were cured with additional dosing. Acute infusion-related reactions occurred in 25% and mild renal toxicity occurred in 45% of patients. Although the optimum dosing regimen is undefined and the cost and toxicity may limit widespread use, liposomal amphotericin B is a viable treatment alternative for cutaneous leishmaniasis.