Table 5 Summary of recommended treatment regimens^{12 56} .

Disease pattern	Drug	Dose	Comments (level of evidence, when available, in brackets)
Visceral leishmaniasis	Miltefosine	2.5 mg/kg/day PO (od or bd) ×28 days	(A)
	Liposomal amphotericin B	2 mg/kg/day IV ×5 days	(A)
	Pentavalent antimony (as stibogluconate or meglumine antimonate)	20 mg/kg/day IM or IV ×28 days	(Some experts advise not exceeding 850 mg od,42 not effective in northern Bihar, India
Mucocutaneous leishmaniasis	As with VL
	Amphotericin B	1 mg/kg IV qod ×20–30 doses	This may be better than antimonials in mucosal disease
Cutaneous leishmaniasis	Observation alone		L major (A) and L mexicana (B)
	Pentavalent antimony (as stibogluconate or meglumine antimonate)	20 mg/kg/day IM or IV ×20 days (×10 days in L major, L tropica and L mexicana)	(Some experts advise not exceeding 850 mg od)
	Fluconazole	200 mg PO od	L major (A)
	Ketoconazole	600 mg PO od ×28 days	L panamensis (A)
			L mexicana (A)
	Miltefosine	2.5 mg/kg PO od ×28 days	L panamensis (A)
	Pentavalent antimony	Intralesional: 1 ml per lesion qod ×8–15 times	L major every 1–2 weeks ×3–8 times (A)
			L tropica weekly × 8–11 times (C)
	Pentamidine	2–4 mg/kg od or every 2 days IV ×15 doses	L panamensis and L braziliensis
			L guyanensis (D)
	Paromomycin	Topical bd	L major ×4 weeks (A)
			L mexicana ×20 days (B)

bd, twice daily; IM, intramuscular; IV, intravenous; od, once daily; PO, orally; qod, every other day.

Grades of recommendations based on best available evidence: (A) randomised, controlled trial in representative collective;(B) randomised, controlled trial in partially representative (small patient number, different species included) collective, cohort trial or case–control study in representative collective; (C) series of cases in partially representative (small patient number, different species included) collective, informal expert opinion, other information; (D) cohort trial or case–control study in partially representative collective, series of cases in representative collective.