Leishmaniasis

Treatment

Diagnosis: microscopy or PCR in smears, body fluids or tissue

  Drug / Dose Comments
Preferred treatment  liposomal amphotericin B 
2-4 mg/kg qd iv for 10 consecutive days
Then secondary prophylaxis
OR liposomal amphotericin B
4 mg/kg qd iv on day 1-5, 10, 17, 24, 31 and 38
 
Alternative therapy    lipid complex amphotericin B
3 mg/kg qd iv
10 days
OR amphotericin B deoxycholate
0.5-1 mg/kg qd iv (total dose 1.5-2 g)
 
OR pentavalent antimonium salt (Glucantime®)
20 mg/kg qd iv or im
4 weeks
OR miltefosine
100 mg/kg qd po
4 weeks

Secondary Prophylaxis/ Maintenance Therapy

Consider stopping: if CD4 count > 200-350 cells/μL and HIV-VL undetectable over 3 months, no relapse for at least 6 months and negative PCR in blood or negative urinary antigen

  Drug / Dose
Preferred treatment liposomal amphotericin B
4 mg/kg every 2-4 weeks iv
  OR lipidcomplex amphotericin B
3 mg/kg every 3 weeks iv
Alternative therapy pentavalent antimonium salts (Glucantime®)
20 mg/kg every 4 weeks iv/im
  OR miltefosine
100 mg qd po
  OR pentamidine
300 mg every 3 to 4 weeks iv