High frequency of serious side effects from meglumine antimoniate given without an upper limit dose for the treatment of visceral leishmaniasis in human immunodeficiency virus type-1-infected patients

Organic pentavalent antimonials are one of the mainstays of treatment for v isceral leishmaniasis (VL). Few data are available on the toxicity and effi cacy of these drugs at the dosing schedule recommended by the Centers for D isease Control and Prevention (CDC) (Atlanta, GA), We analyzed 25 VL episod es in human immunodeficiency virus (HIV)-infected patients who were heated with meglumine antimoniate (MA) at the CDC-recommended dose in southern Spa in. Adverse effects were observed in 14 (56%) VL episodes. In 7 (28%), trea tment with MA was permanently discontinued due to serious adverse effects t hat included acute pancreatitis, acute renal failure, and leukopenia. Three (12%) patients died during therapy due to severe acute pancreatitis attrib utable to MA. The dosing regimen of MA currently recommended for treating V L is associated with a high rate of serious side effects in HIV-infected pa tients.