Table of Contents
Can leishmaniasis be treated with antibiotics?
Pentamidine is a first-line medication in cutaneous leishmaniasis except for L mexicana (ketoconazole 600 mg PO qd for 28 days). It is a treatment alternative in visceral leishmaniasis. Available antibiotic preparations include pentamidine isethionate (Pentam) and pentamidine dimethanesulfonate (Lomidine).
Which drug is used in leishmaniasis?
The main drugs available for treatment of VL are the systemic agents like antimony, amphotericin, paromomycin and now the oral drug miltefosine. All these drugs will be discussed in detail and the evidence for their use in particular settings noted.
What is the mode of action for pentamidine?
Due to its mechanism of action, which includes inhibition of protein and RNA synthesis and antagonism of receptors, pentamidine affects multiple organs producing various adverse effects. Endocrine – Most commonly, it causes hypoglycemia due to pancreatic islet cell damage and very rarely hyperglycemia.
How do you administer pentamidine?
It is given using a special machine called a nebulizer that changes the solution to a fine mist that you inhale. Each treatment usually takes 30 to 45 minutes. You may also be given another inhaled medication (such as albuterol) to help open your airways before each treatment with pentamidine.
How does allopurinol treat leishmaniasis?
There is evidence that allopurinol can inhibit the growth of leishmania in vitro and in tissue culture. Allopurinol and pentostam (a pentavalent antimonial agent) have a synergistic action against leishmania in tissue culture.
Why is pentamidine given?
Pentamidine is used to try to prevent Pneumocystis carinii pneumonia (PCP), a very serious type of pneumonia. This type of pneumonia occurs commonly in patients whose immune systems are not working normally, such as patients with acquired immune deficiency syndrome (AIDS).
What are Antimonial drugs?
Antimonials, in pre-modern medicine, were remedies principally containing antimony, used chiefly for emetic purposes. They might also have qualified for cathartic, diaphoretic, or simply alternative uses. Such treatments were considered unparalleled in their strength.
Why is VL called kala-azar?
Leishmaniasis is caused by a protozoa parasite from over 20 Leishmania species. Over 90 sandfly species are known to transmit Leishmania parasites. There are 3 main forms of the disease: Visceral leishmaniasis (VL), also known as kala-azar is fatal if left untreated in over 95% of cases.
Is allopurinol an immunosuppressant?
Allopurinol demonstrated to have an immunosuppressive action when given at the dose of 200 microgram daily to the mice receiving skin grafts.
Why amphotericin B is given in kala-azar?
Amphotericin B deoxycholate has been used in India for treatment of visceral leishmaniasis (kala-azar) for >1 decade. Its rediscovery as effective treatment for Leishmania donovani infection was spawned by the development of large-scale resistance to conventional pentavalent antimony therapy in Bihar State [1].