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Comparative study on liposomal amphotericin B and other therapies in the treatment of mucosal leishmaniasis: A 15-year retrospective cohort study

Author

Listed:
  • Carolina Rocio Santos
  • Felipe Francisco Tuon
  • Juliette Cieslinski
  • Regina Maia de Souza
  • Rui Imamura
  • Valdir Sabbaga Amato

Abstract

Background: Liposomal amphotericin B (L-AMB) has been used for mucosal leishmaniasis (ML), but comparative studies on L-AMB and other drugs used for the treatment of ML have not been conducted. The present study aimed to evaluate the outcome of patients with ML who were treated with L-AMB. Methods: This is a 15-year retrospective study of Brazilian patients with a confirmed diagnosis of ML. The therapeutic options for the treatment of ML consisted of L-AMB, amphotericin B lipid complex (ABLC), deoxycholate amphotericin B (d-AMB), itraconazole, antimonial pentavalent, or pentamidine. Healing, cure rate and adverse effects (AEs) associated with the drugs used to treat this condition were analyzed. Results: In 71 patients, a total of 105 treatments were evaluated. The outcome of the treatment with each drug was compared, and results showed that L-AMB was superior to other therapeutic regimens (P = 0.001; odds ratio [OR] = 4.84; 95% confidence interval [CI] = 1.78–13.17). d-AMB had worse AEs than other treatment regimens (P = 0.001, OR = 0.09; 95% CI = 0.09–0.43). Approximately 66% of the patients presented with AEs during ML treatment. Although L-AMB was less nephrotoxic than d-AMB, it was associated with acute kidney injury compared with other drugs (P

Suggested Citation

  • Carolina Rocio Santos & Felipe Francisco Tuon & Juliette Cieslinski & Regina Maia de Souza & Rui Imamura & Valdir Sabbaga Amato, 2019. "Comparative study on liposomal amphotericin B and other therapies in the treatment of mucosal leishmaniasis: A 15-year retrospective cohort study," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-12, June.
    • Handle: RePEc:plo:pone00:0218786
    DOI: 10.1371/journal.pone.0218786
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