22
Treatment
Table 3a. Approach to Syndromic Treatment of Cutaneous
Leishmaniasis (CL) in North America
1,2
Treatment
Classification
Generic (Brand)
Source and Availability Regimen
Treatment of
choice
ere is no generally applicable treatment of choice; choice should
be individualized.
Parenteral
alternatives
Amphotericin B deoxycholate
(Fungizone
®
)
Bristol Myers Squibb
0.5–1.0 mg/kg per dose
daily or every other day for
cumulative total of ~15–
30 mg/kg IV
Pentavalent antimonials
4
(In some settings, treatment for as
few as 10 days has been effective.)
Sodium stibogluconate (Pentostam
®
)
GlaxoSmithKline
• For military health care
beneficiaries, contact Force Health
Protection Division, US Army
Medical Materiel Development
Activity (USAMMDA).
13
20 mg Sb
V
/kg/day for 20
days IV, IM (IV preferred in
North America
1
)
Meglumine antimoniate
(Glucantime
®
)
Sanofi
• In Canada, via Special Access
Program
As per Pentostam
®
Liposomal amphotericin B
(AmBisome
®
)
Astellas
3 mg/kg/day on days 1–5
and 10 or on days 1–7 (total
18–21 mg/kg ) IV
Pentamidine isethionate
(Pentam 300
®
)
APP Pharmaceuticals
3–4 mg/kg every other day
for 3 or 4 doses (IV preferred
in North America1)
Oral
alternatives
Azoles
Fluconazole (Diflucan
®
)
Pfizer
Adults: 200 mg daily for 6
weeks PO
Ketoconazole (Nizoral
®
)
Janssen
Adults: 600 mg daily for 28
days PO
Miltefosine (Impavido
®
)
• In US: Knight Therapeutics via
Profounda, the US marketer.
• In Canada: via Special Access
Program
FDA-approved regimen:
• 30–44 kg : 50 mg bid for
28 days PO
• ≥45 kg : 50 mg tid for 28
days PO
