Effectiveness and Safety of Amphotericin B Deoxycholate, Amphotericin B Colloidal Dispersion, and Liposomal Amphotericin B as Third-Line Treatments for Cutaneous and Mucocutaneous Leishmaniasis: A Retrospective Study

Am J Trop Med Hyg. 2020 Feb;102(2):274-279. doi: 10.4269/ajtmh.18-0514.

Abstract

Cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (MCL) are endemic diseases in America, especially in some countries such as Colombia. Among the therapeutic options is amphotericin B (AB). Nevertheless, its lipid-associated formulations have better safety profiles and effectiveness in other diseases, so far with no comparative studies in CL or MCL. We conducted a retrospective descriptive study describing the effectiveness and adverse effects of AB deoxycholate (ABD), AB colloidal dispersion (ABCD), and liposomal AB (LAB) as third-line treatments for CL and MCL. The effectiveness of LAB (88.5%) was greater than those of ABCD (66.6%) and ABD (80.8%). There were also fewer adverse effects in the LAB group (46.2%) than in the ABD (96.1%) and ABCD (80.9%) groups. LAB is an alternative for the treatment of CL and MCL in patients with therapeutic failure to first- and second-line drugs; findings suggest it might be less toxic and more effective than ABD and ABCD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amphotericin B / adverse effects*
  • Amphotericin B / therapeutic use*
  • Antiprotozoal Agents / adverse effects
  • Antiprotozoal Agents / therapeutic use
  • Colloids
  • Colombia / epidemiology
  • Deoxycholic Acid / adverse effects
  • Deoxycholic Acid / therapeutic use*
  • Drug Combinations
  • Humans
  • Leishmaniasis, Cutaneous / drug therapy*
  • Leishmaniasis, Cutaneous / epidemiology
  • Leishmaniasis, Mucocutaneous / drug therapy*
  • Leishmaniasis, Mucocutaneous / epidemiology
  • Retrospective Studies

Substances

  • Antiprotozoal Agents
  • Colloids
  • Drug Combinations
  • liposomal amphotericin B
  • Deoxycholic Acid
  • Amphotericin B
  • amphotericin B, deoxycholate drug combination