Table 10.9-1. Systemic treatment of leishmaniasis in adults

Agent

Dosage

Visceral leishmaniasis

 

Liposomal amphotericin B

3 mg/kg IV once daily for 5 days, then after 14 and 21 days from initiation of treatment until the total dose of 21 mg/kg is achieved

Antimony(V) compounds (sodium stibogluconate, meglumine antimoniate)

20 mg of antimony/kg IV or IM once daily for 28 days

Miltefosine

2.5 mg/kg PO in 2-3 divided doses for 28 days

Cutaneous leishmaniasis

 

Fluconazole

200 mg PO once daily for 6 weeks

Ketoconazole

600 mg PO once daily for 4 weeks

Miltefosine

2.5 mg/kg PO (up to 150 mg) in 3 divided doses for 28 days

Antimony(V) compounds (sodium stibogluconate, meglumine antimoniate)

20 mg of antimony/kg IV or IM once daily for 10-20 days

Liposomal amphotericin B

3 mg/kg IV once daily for 6-7 days

Pentamidine isethionate

Drug of choice (4 mg of salt/kg IV or IM at an interval of 48 h) for cutaneous leishmaniasis caused by Leishmania (Viannia) guyanensis

IM, intramuscular; IV, intravenous; PO, orally.