USE OF AMPHOTERICIN-B IN DRUG-RESISTANT CASES OF VISCERAL LEISHMANIASIS IN NORTH BIHAR, INDIA

Thirty-four multidrug-resistant cases of Indian visceral leishmaniasis (kala-azar) were treated with amphotericin B. A complete hemogram, li ver and renal function tests, determination of serum electrolyte level s, a chest radiograph, and an electrocardiogram were done before, duri ng, and after completion of therapy. Assessment for clinical and paras itologic cure was done weekly. Thirty-one patients who completed treat ment had full cure after receiving 10-15 injections at six-months foll ow up. One patient died of myocarditis. A febrile reaction was observe d in all cases, while thrombophlebitis was found in six cases (18.75%) . Anorexia, nausea, and vomiting were found in seven cases (21.88%). N o significant nephrotoxicity or electrolyte disturbances were observed . It is concluded that amphotericin B is an effective second-line drug for Indian visceral leishmaniasis, but unpredictable drug-induced myo carditis remains a problem.