SHORT-COURSE TREATMENT OF VISCERAL LEISHMANIASIS WITH LIPOSOMAL AMPHOTERICIN-B (AMBISOME)

We evaluated liposomal amphotericin B (AmBisome; Vestar, San Dimas, CA ) administered to 88 immunocompetent patients (56 children) with visce ral leishmaniasis (VL) caused by Leishmania infantum. Thirteen patient s received 4 mg/kg on days 1-5 and 10 (total dose, 24 mg/kg), and all were cured; 42 received 3 mg/kg on days 1-5 and 10 (18 mg/kg), and 41 were cured; 32 received 3 mg/kg on days 1-4 and 10 (15 mg/kg), and 29 were cured (amastigotes were not cleared from 1 child, and 2 relapsed) . One adult was cured with a total dose of 12 mg/kg. The four children who were not cured received 3 mg/kg for 10 days; none had further rel apses. There were no significant adverse events. For VL due to L. infa ntum, we recommend a total dose of AmBisome of greater than or equal t o 20 mg/kg, given in greater than or equal to 5 doses of 3-4 mg/kg ove r greater than or equal to 10 days.