Table 3 Recommended treatment regimens for VL in Indian subcontinent (ranked by preferences)

1.

Liposomal amphotericin B: 3–5 mg/kg per daily dose by infusion given over 3–5-day period up to a total dose of 15 mg/kg (A) by infusion or 10 mg/kg as a single dose by infusion (A).

2.

Combinations (co-administered) (A)

• liposomal amphotericin B (5 mg/kg by infusion, single dose) plus miltefosine (daily for 7 days, as below)

• liposomal amphotericin B (5 mg/kg by infusion, single dose) plus paromomycin (daily for 10 days, as below)

• miltefosine plus paromomycin, both daily for 10 days, as below.

3.

Amphotericin B deoxycholate: 0.75–1.0 mg/kg per day by infusion, daily or on alternate days for 15–20 doses (A).

4.

Miltefosine: for children aged 2–11 years, 2.5 mg/kg per day; for people aged ≥12 years and <25 kg body weight, 50 mg/day; 25–50 kg body weight, 100 mg/day; >50 kg body weight, 150 mg/day; orally for 28 days (A) or Paromomycin: 15 mg (11 mg base) per kg body weight per day intramuscularly for 21 days (A).

5.

Pentavalentantimonials: 20 mg Sb5+/kg per day intramuscularly or intravenously for 30 days in areas where they remain effective: Bangladesh, Nepal and the Indian states of Jharkhand, West Bengal and Uttar Pradesh (A).