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JAC Advance Access originally published online on May 18, 2004
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Journal of Antimicrobial Chemotherapy 2004 54(1):217-220; doi:10.1093/jac/dkh279
JAC vol.54 no.1 © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved.

A 6 day course of liposomal amphotericin B in the treatment of infantile visceral leishmaniasis: the Italian experience

Antonio Cascio1,2,*, Lucio di Martino3, Paolo Occorsio3, Raffaella Giacchino4, Salvatore Catania5, Anna Rita Gigliotti4, Camilla Aiassa5, Chiara Iaria1,2, Salvatore Giordano6, Claudia Colomba6, Valentina Frasca Polara6, Lucina Titone6, Luigi Gradoni7, Marina Gramiccia7 and Spinello Antinori8

1 Clinica Malattie Infettive, Università di Messina, Messina; 2 AILMI (Associazione Italiana per la Lotta contro le Malattie Infettive) ONLUS, Messina; 3 U.O. di Pediatria Infettivologica, A.O. Santobono-Pausilipon, Napoli; 4 Unità Operativa di Malattie Infettive, Istituto G. Gaslini, Genova; 5 Dipartimento Malattie Infettive, Policlinico Umberto I, Università La Sapienza Roma, Rome; 6 Istituto di Patologia Infettiva e Virologia, Università di Palermo, Palermo; 7 Laboratorio di Parassitologia, Istituto Superiore di Sanità, Rome; 8 Istituto di Malattie Infettive e Tropicali, Università di Milano, Milan, Italy

* Correspondence address. Clinica Malattie Infettive, Università di Messina, Via Consolare Valeria n. 1, 98125 Messina, Italy. Tel: +39-090-221-2033; Fax: +39-178-225-6846; Email: acascio{at}unime.it

Objectives: To evaluate in a retrospective analysis the efficacy and safety of a 6 day course of liposomal amphotericin B (L-AmB) in infantile cases of Mediterranean visceral leishmaniasis (VL) diagnosed over a 10 year period in Italy.

Patients and methods: Patients included were diagnosed as having VL consecutively admitted from December 1992 to December 2001 at four main referral children's hospitals in Italy and treated with six intravenous doses of 3 mg/kg L-AmB given on days 1–5 and 10 (a total dose of 18 mg/kg). Demographic data, nutritional status, underlying diseases, clinical and laboratory findings, and therapy outcome were considered.

Results: A total of 164 HIV-negative children (median age 1.6 years; range 4 months to 14 years) were enrolled. All patients were initially cured by the given treatment, and did not present adverse events related to drug infusion. Seven patients (4.3%) had a clinical and parasitological relapse 3–15 months after therapy. All relapses were successfully retreated with 3 mg/kg L-AmB for 10 consecutive days (a total dose of 30 mg/kg).

Conclusions: This study highlights the efficacy (>95%) and safety of the six dose L-AmB regimen and validates it as a first-line treatment for Mediterranean VL in children.

Keywords: Leishmania infantum , Italy , therapy


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