COST, EFFICACY AND SAFETY OF AMINOSIDINE (PAROMOMYCIN) IN THE TREATMENT OF VISCERAL LEISHMANIASIS

Aminosidine (Paromomycine)

Abstract

Objective: To compare Aminosidine as a single agent in the treatment of visceral leishmaniasis with antimony compounds.

Design: Open non-randomized, interventional study of three drugs used in Pakistan for visceral leishmaniasis.

Setting: Military hospitals at Muzaffarabad Azad-Kashmir and Rawalpindi (reservoir for visceral leishmaniasis in Pakistan) over a period of five years.

Patients and Methods: Children up-to 12 years of age diagnosed as visceral leishmaniasis (LD-bodies positive). Patients were divided into three groups of 30 patients each. Every patient received either sodium stibogluconate or meglumine antimonate @ 20 mg/kg/day for 28 days or the trial agent Aminosidine @15mg/kg/day for 21 days.

Results: Most patients were less than 36 months of age (82.2%) while there was male predilection (1.2:1). Fever, hepatosplenomegaly and pancytopenia were seen in 100% cases with malnutrition in 71%, cough in 51%, lymphadenopathy in 23.3% and bleeding diathesis 40% being the other common features. Three agents were found to be effective (to a different degree) as regards defervesence, reduction in size of enlarged organs, recovery of bone-marrow function manifested by improvement in hematological parameters. No major side effects were detected clinically or by laboratory studies. Cost of therapy was also remarkably lower for aminosidine as compared to the antimonials.

Conclusion: Aminosidine as a single agent is much cheaper, effective and a safe drug suitable for treatment of visceral Leishmaniasis in Pakistan.