IDSA GUIDELINES Bundle (free trial)

Leishmaniasis

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35 Avoid/minimize use of other agents (eg, drugs linked to QTc prolongation). Interrupt Sb V therapy if QTc prolongation (eg, if QTc >0.50 sec), concave ST segments, clinically relevant arrhythmias, or moderate-to-severe clinical pancreatitis. resholds for interrupting therapy if asymptomatic laboratory abnormalities (eg, elevated aminotransferase levels) should be individualized. Nonsteroidal antiinflammatory drugs may be used for symptomatic therapy. Avoid rigorous physical activity. Not formally assigned to an FDA pregnancy category (see Recs. 78-79) Probably compatible (see Recs. 78-79). Interruption of breastfeeding may be prudent. Patients with advanced immunosuppression (eg, AIDS) may have life- threatening pancreatitis or cardiotoxicity (see Recs. 61- 66). See Recs. 78-79 regarding considerations for other special populations (eg, children). To minimize risk for hypotension, infuse drug over 1–2 h; keep patient supine; check vital signs before, during, and aer infusion (or injection) until stable. Avoid/minimize use of other agents, including nephrotoxic drugs. Typically, NOT warranted or recommended for antileishmanial treatment during pregnancy. Selection of a different drug or interruption of breastfeeding may be prudent. Mitigation and Management Approaches d,f Pregnant Patients f,g Breastfeeding Patients f,h Comments

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