Amphotericin B treatment for Indian visceral leishmaniasis: Conventional versus lipid formulations

被引:145
作者
Sundar, S
Mehta, H
Suresh, AV
Singh, SP
Rai, M
Murray, HW
机构
[1] Banaras Hindu Univ, Inst Med Sci, Dept Med, Kala Azar Med Res Ctr, Varanasi 221005, Uttar Pradesh, India
[2] Cornell Univ, Weill Med Coll, Dept Med, New York, NY USA
关键词
D O I
10.1086/380971
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
In Bihar, India, where visceral leishmaniasis is hyperendemic, amphotericin B deoxycholate is now first-line parenteral treatment. To test the efficacy of amphotericin B deoxycholate versus that of its lipid formulations, Indian patients were randomized to receive treatment with amphotericin B deoxycholate (1 mg/kg on alternate days for 30 days; n = 51), liposomal amphotericin B ( 2 mg/kg per day for 5 days; n = 51), or amphotericin B lipid complex ( 2 mg/ kg per day for 5 days; n = 51). Infusion-associated reactions were frequent and persistent in subjects treated with amphotericin B deoxycholate. The illness of 3 patients failed to respond to treatment, and 5 patients experienced relapse. Final cure rates were similar. Estimated total treatment costs for a 25-kg patient -$417 for amphotericin B deoxycholate, $872 for liposomal amphotericin B, and $947 for amphotericin B lipid complex - differed as a result of drug cost. Substantial reductions (similar to 60%) in the price of liposomal amphotericin B and amphotericin B lipid complex would make treatment costs comparable to that of amphotericin B deoxycholate, permitting administration of short-course regimens in India.
引用
收藏
页码:377 / 383
页数:7
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