DOC for management of visceral Leishmaniasis:
Ref: Goodman & Gillman 13th ed. P 996* Drug of choice for visceral leishmaniasis: Liposomal Amphotericin B.# Note: AmpB can be used even during pregnancy# Side effect: Renal toxicity, hypokalemia, hypomagnesemia* Other agents for management of leishmaniasis:# Sodium stibogluconate: Given parenterally 20mg/kg/day for 20 days in cutaneous disease and 28 days in visceral leishmaniasis. Due to increased resistance it has now become obsolete in India. At present oral preparation is available and shows better result.- Side effect: Pancreatitis, Hepatotoxicity, Bone marrow suppression, haemolytic anemia and renal failure# Pentamidine can be used in doses of 2-3mg/kg IV or IM daily or every second day for 4-7 doses to treat cutaneous leishmaniasis.- Side effect: Nephrotoxic, Hypoglycemia# Miltefosine: Oral agent. Can be used in visceral and cutaneous leishmaniasis.- Only oral preparation available. Teratogenic - Not used in pregnancy
Parenteral Sodium stibogluconate
Liposomal Amphotericin B
Miltefosine
Pentamidine
Anti Microbial