Visceral leishmaniasis treatment in children.

Visceral leishmaniasis is an endemic disease in the Mediterranean Basin. Ch ildren are one of the targets of the infection. Treatment usually requires parenteral injections of pentavalent antimony (Glucantime(R) or Pentostam(R )), but the high frequency of adverse events and the occurrence of primary or secondary resistance cases limit the use of these medications. Diamidine s (Pentacarinat(R)) or amphotericin B derivatives are alternatives to antim ony. Unfortunately, pharmacokinetics and optimal dosage of diamidines are n ot well-known, and numerous adverse events are described. Liposomal prepara tions of amphotericin B enhance its efficiency and tolerance, and the durat ion of treatment may be reduced to 5 days. Moreover, primary resistance to amphotericin B is not described in immunocompetent children. Allopurinol as sociated with antimony seems no more efficient than antimony alone. Aminosi dine is not evaluated. (C) 1999 Elsevier, Paris.