Treatment for kala-azar (Visceral Leishmaniasis)

Written by Dr.Md.Redwanul Huq (Masum)
Monday, 20 June 2011 15:33

General treatment:

1. Proper nutrition should be ensured
2. Intercurrent infection(s) should be treated
3. Ferrous sulphate, folic acid or blood transfusion should be given according to Hb level.
4. Inj. Vitamin K should be given IV – if there is hemorrhage.

Specific treatment:

Treatment- A (For Kala-azar):

Sodium antimony gluconate (SAG)-100 mg/ml is given IV or IM at a dose of 20 mg/kg/day for 20 days.

Maximum daily adult does should not exceed 850 mg (8.5 ml). This treatment for leishmaniasis is contraindicated if the patient has severe renal, cardiac or hepatic impairments.

Treatment- B [For Kala-azar Treatment failure (KATF)]:

Step 1– Pentamidine (isoethionate)-50 mg/ml is given deep IM at a dose of 4 mg/kg three times a week for 5 wks(i.e.15 injections).This treatment is contraindicated if the patient has severe renal impairment.
Step 2- On the 6th week i.e. after completion of pentamidine course, treatment should be continued with SAG daily for 30 days as per treatment – A.

Treatment- C (For Post Kala-azar Dermal Leishmaniasis):

SAG should be given at a dose of 20 mg/kg /day for 20 days according to treatment-A. This treatment-A cycle is repeated for 6 times. Between each treatment cycle there will be a 10 days interval.

Treatment of relapse of Kala-azar:

SAG should be given at a dose of 20 mg/kg /day for double duration of treatment – A i.e. for 40 days.

Treatment of resistent Kala-azar:

Amphotericin-B is used.

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