Amphotericin

Liposomal amphotericin B (ambisome) cures nearly 100% of cases of visceral leishmaniasis and has become the drug of choice for antimonial-resistant disease. Likely due to pharmacokinetic considerations, it is not useful against cutaneous or mucosal leishmaniasis. The recommended dose for the treatment of visceral leishmaniasis is 3 mg/kg/day intravenously for days 1—5, 14, and 21, with the dose being increased to 4 mg/kg and extended to days 1—5, 10, 17, 24, 31, and 38 for immunosuppressed patients. Shorter courses of the drug provide a lower-cost alternative. Cure rates are ~90% with either regimen.

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