Safety and efficacy of intravenous sodium stibogluconate in the treatment of leishmaniasis: Recent US military experience

The efficacy and toxicity of sodium stibogluconate (SSG) at a dosage of 20 mg/(kg.d) for either 20 days (for cutaneous disease) or 28 days (for viscer al, mucosal, or viscerotropic disease) in the treatment of leishmaniasis is reported. Ninety-six U.S. Department of Defense health care beneficiaries with parasitologically confirmed leishmaniasis were prospectively followed for 1 year. One patient was infected with human immunodeficiency virus; oth erwise, comorbidity was absent. Clinical cure occurred in 91% of 83 cases o f cutaneous disease and 93% of 13 cases of visceral/viscerotropic disease. Adverse effects were common and necessitated interruption of treatment in 2 8% of cases, but they were generally reversible. These included arthralgias and myalgias (58%), pancreatitis (97%), transaminitis (67%), headache (22% ), hematologic suppression (44%), and rash (9%), No subsequent mucosal leis hmaniasis was identfied, and there were no deaths attributable to SSG or le ishmaniasis.