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

From: Current challenges in treatment options for visceral leishmaniasis in India: a public health perspective

Anthroponotic VL caused by L.donovani in India, Bangladesh, Bhutan and Nepal
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).
  1. Note: Amphotericin-B or Liposomal amphotericin B at higher dose should be used as rescue treatment in case of non-response
  2. Source: WHO Technical Report Series (2010) Control of the leishmaniasis. WHO,Geneva [83]
  3. Grade of evidence (A)- evidence based on at least one randomized controlled trial