Oral Miltefosine for Indian Visceral Leishmaniasis

Miltefosine has been shown to have activity against Indian visceral leishmaniasis, and this agent can be taken orally. This randomized trial in India compared miltefosine treatment with intravenously administered amphotericin B, the most effective standard treatment. The initial cure rate was 100 percent in both groups. After six months, 94 percent of the 299 patients in the miltefosine group were deemed to be cured. Oral miltefosine was as effective as amphotericin B, which must be administered parenterally. Visceral leishmaniasis is caused by infection of the visceral reticuloendothelial system by leishmania species acquired from sandfly bites. There are approximately 500,000 cases per year, with the majority in northeastern India, Nepal, and Bangladesh. Other areas where visceral leishmaniasis is endemic include East Africa, the littoral region of the Mediterranean, and Brazil. 1 The disease presents with fever, hepatosplenomegaly, and pancytopenia. Almost all untreated patients die, generally because of intercurrent infection. 2 , 3 Both standard treatment and secondary treatment are parenteral. Standard treatment consists of daily injections of pentavalent antimonial compounds for 28 days. In regions of India where there is a . . .