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A comparison of liposomal Amphotericin B with sodium stibogluconate for the treatment of visceral leishmaniasis in pregnancy in Sudan | Journal Article / Research | MSF Science Portal
Journal Article
|Research

A comparison of liposomal Amphotericin B with sodium stibogluconate for the treatment of visceral leishmaniasis in pregnancy in Sudan

Mueller M, Balasegaram M, Koummuki Y, Ritmeijer KKD, Santana MR, Davidson RN
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Abstract
OBJECTIVES: Little is known about the treatment of visceral leishmaniasis (VL) in pregnancy, especially in resource-poor settings. We present a series of pregnant women with VL treated with either sodium stibogluconate or liposomal amphotericin B (AmBisome), or both, in eastern Sudan over 16 months.

METHODS: We did a retrospective analysis of all pregnant VL patients treated in the Médecins sans Frontières (MSF) Um el Kher centre between January 2004 and April 2005. We diagnosed VL with laboratory confirmation of clinical suspects, and recorded the outcomes of treatment for pregnant women and their foetuses. We carried out a manual search of relevant publications and a systematic search of the literature in the MEDLINE database.

RESULTS: We treated 23 women with sodium stibogluconate, 4 with AmBisome and sodium stibogluconate and 12 with AmBisome alone. There were 13 (57%) spontaneous abortions in the sodium stibogluconate monotherapy group, and none in either of the other two groups. All spontaneous abortions occurred in the first two trimesters. All patients, except one in the sodium stibogluconate group who defaulted, were discharged as cured in good clinical condition.

CONCLUSIONS: AmBisome treatment for VL appears to be safe and effective for pregnant women and their foetuses. We recommend the use of AmBisome as first-line treatment for these patients.

Subject Area

women's healthkala azar

Languages

English
DOI
10.1093/jac/dkl342
Published Date
01 Oct 2006
PubMed ID
16916865
Journal
Journal of Antimicrobial Chemotherapy
Volume | Issue | Pages
Volume 58, Issue 4, Pages 811-815
Issue Date
2006-07-19
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