Table 1.

Recommendations of the World Health Organization for the treatment of visceral leishmaniasis per geographic region ranked by preference [World Health Organization (59)].

ANTHROPONOTIC VISCERAL LEISHMANIASIS CAUSED BY L. donovani IN THE INDIAN SUBCONTINENT

Liposomal amphotericin B: 3–5 mg/kg daily over 3–5 days to a total dose of 15 mg/kg by infusion or 10 mg/kg as a single dose

Combination therapy (co-administered following the sequence): (i) liposomal amphotericin B (5 mg/kg by infusion, single dose) + miltefosine (daily for 7 days, dosage as below), (ii) liposomal amphotericin B (5 mg/kg by infusion, single dose) + paromomycin (daily for 10 days, dosage as below), (iii), miltefosine + paromomycin both for 10 days (dosages as below)

Amphotericin B deoxycholate: 0.75–1.0 mg/kg daily or on alternate days for 15–20 doses by infusion

Miltefosine: children aged 2–11 years, 2.5 mg/kg daily; 12 years and older <25 kg body weight, 50 mg/day; 25–50 kg, 100 mg/day; >50 kg, 150 mg/day; orally for 28 days

Paromomycin: 15 mg (11 mg base)/kg/day by intramuscular route for 21 days

Pentavalent antimonials: 20 mg SbV/kg/day intramuscularly or by infusion for 30 days (areas where they are effective: Bangladesh, Nepal, and the Indian states of Jharkhand, West Bengal, and Uttar Pradesh)

VISCERAL LEISHMANIASIS CAUSED BY L. donovani IN EAST AFRICA

Combination therapy: pentavalent antimonials (20 mg SbV/kg/day intramuscularly or by infusion) + paromomycin [15 mg (11 mg base)/kg/day by intramuscular route] for 17 days

Pentavalent antimonials: same treatment scheme as above

Liposomal amphotericin B: 3–5 mg/kg daily given over 6–10 days for a total dose of 30 mg/kg by infusion

Amphotericin B deoxycholate: same treatment scheme as above

Miltefosine: same treatment scheme as above

VISCERAL LEISHMANIASIS CAUSED BY L. infantum

Liposomal amphotericin B: 3–5 mg/kg daily over 3–6 days for a total dose of 18–21 mg/kg by infusion

Pentavalent antimonials: 20 mg SbV/kg/day intramuscularly or by infusion for 28 days

Amphotericin B deoxycholate: 0.75–1.0 mg/kg daily or on alternate days for 10–20 doses by infusion (total dose: 2–3 g)