Journal Article

Amphotericin B Treatment for Indian Visceral Leishmaniasis: Conventional versus Lipid Formulations

Shyam Sundar, Himanshu Mehta, A. V. Suresh, Shri P. Singh, Rai Madhukar and Henry W. Murray

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 3, pages 377-383
Published in print February 2004 | ISSN: 1058-4838
Published online February 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/380971
Amphotericin B Treatment for Indian Visceral Leishmaniasis: Conventional versus Lipid Formulations

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In Bihar, India, where visceral leishmaniasis is hyperendemic, amphotericin B deoxycholate is now first-line parenteral treatment. To test the efficacy of amphotericin B deoxycholate versus that of its lipid formulations, Indian patients were randomized to receive treatment with amphotericin B deoxycholate (1 mg/kg on alternate days for 30 days; n = 51), liposomal amphotericin B (2 mg/kg per day for 5 days; n = 51), or amphotericin B lipid complex (2 mg/kg per day for 5 days; n = 51). Infusion-associated reactions were frequent and persistent in subjects treated with amphotericin B deoxycholate. The illness of 3 patients failed to respond to treatment, and 5 patients experienced relapse. Final cure rates were similar. Estimated total treatment costs for a 25-kg patient—$417 for amphotericin B deoxycholate, $872 for liposomal amphotericin B, and $947 for amphotericin B lipid complex—differed as a result of drug cost. Substantial reductions (∼60%) in the price of liposomal amphotericin B and amphotericin B lipid complex would make treatment costs comparable to that of amphotericin B deoxycholate, permitting administration of short-course regimens in India.

Journal Article.  3848 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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