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Safety and efficacy of liposomal amphotericin B for treatment of complicated visceral leishmaniasis in patients without HIV, North-West Ethiopia
4th International Congress on Infectious Diseases
Aschalew Tamiru, Bethlehem Tigabu, Sisay Yifru, Ermias Diro and Asrat Hailu
University of Gondar, Ethiopia
Posters & Accepted Abstracts: J Infect Dis Ther
Abstract
Background & Aim: Visceral leishmaniasis (VL) is a protozoan disease that is fatal if left untreated. The mainstay of treatment in resource limited countries are antimonials, while use of liposomal amphotericin B is reserved for treatment of complicated VL cases. The aim of this study was to assess the safety and efficacy of liposomal amphotericin B in HIV negative VL patients with complications. Methods: A retrospective chart review was conducted involving records of patients admitted between January 2009 and December 2014. Baseline socio-demographic, clinical and treatment outcome data were collected. The doses of liposomal amphotericin B and adverse events related to treatment were retrieved. Categorical and continuous variables respectively were analyzed by Chi-square and Mann-Whitney U tests. A p-value of less than 0.05 was considered statistically significant. Results: A total of 147 patients with severe VL were treated with liposomal amphotericin B in total dose ranges of 20 mg/kg to 35 mg/ kg. In the overall treatment outcome analysis, initial cure was observed in 128 (87.1%), treatment failures in 10 (6.8%), interruptions in two (1.4%) and deaths in seven (4.8%) patients. Initial cure rate at high dose (24-35 mg/kg total dose) was 96.7% (59/61) versus 80.2% (69/86) at lower doses (<24 mg/kg); which was significantly higher (P<0.01), OR=4.56:95%, Confidence Interval (CI) =1.17- 20.78). Nearly 12% of treatment failure occurred in the low dose treatment group. The common adverse events were hypokalemia in 39 cases (26.5%) and infusion related reactions in 16 (10.9%). Hypokalemia and infusion related reactions were not significantly different between the treatment groups. Conclusion: In HIV negative complicated VL patients, high dose of liposomal amphotericin B was found to have high cure rate at the end of treatment. The appropriate dose for better efficacy needs to be determined. Monitoring serum potassium level is essential during treatment of VL with liposomal amphotericin B.Biography
Email: aschex2006@yahoo.com
