Recent strategies for the chemotherapy of visceral leishmaniasis

Visceral leishmaniasis is a widespread and deadly disease. First-line drugs are antimonials, but amphotericin B and its lipid formulations B is used f or treating visceral leishmaniasis that is unresponsive to antimony, New th erapeutic approaches are being actively developed, including the following: use of drug carriers targeted specifically to the parasite location, thus reduce adverse effects of drug; use of immunomodulating drugs; evaluation o f natural products; phamacokinetic studies; and drug combinations. Recent c linical trials with paromomycin and miltefosine were successful and these d rugs appear to be promising for the future therapy of visceral leishmaniasi s. Furthermore, identification and therapeutic evaluation of specific targe ts in the Leishmania organism could lead to new compounds, such as antileis hmanial drugs and reversal agents Of drug resistance. Curr Opin Infect Dis 11:559-564. (C) 1999 Lippincott Williams & Wilkins.