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dc.contributor.authorMueller, M
dc.contributor.authorBalasegaram, M
dc.contributor.authorKoummuki, Y
dc.contributor.authorRitmeijer, K
dc.contributor.authorSantana, M R
dc.contributor.authorDavidson, R N N
dc.date.accessioned2008-02-28T10:49:39Z
dc.date.available2008-02-28T10:49:39Z
dc.date.issued2006-10
dc.identifier.citationA Comparison of Liposomal Amphotericin B with Sodium Stibogluconate for the Treatment of Visceral Leishmaniasis in Pregnancy in Sudan. 2006, 58 (4):811-5 J. Antimicrob. Chemother.en
dc.identifier.issn0305-7453
dc.identifier.pmid16916865
dc.identifier.doi10.1093/jac/dkl342
dc.identifier.urihttp://hdl.handle.net/10144/19292
dc.descriptionTo access this article, click on "Additional Links"
dc.description.abstractOBJECTIVES: Little is known about the treatment of visceral leishmaniasis (VL) in pregnancy, especially in resource-poor settings. We present a series of pregnant women with VL treated with either sodium stibogluconate or liposomal amphotericin B (AmBisome), or both, in eastern Sudan over 16 months. METHODS: We did a retrospective analysis of all pregnant VL patients treated in the Médecins sans Frontières (MSF) Um el Kher centre between January 2004 and April 2005. We diagnosed VL with laboratory confirmation of clinical suspects, and recorded the outcomes of treatment for pregnant women and their foetuses. We carried out a manual search of relevant publications and a systematic search of the literature in the MEDLINE database. RESULTS: We treated 23 women with sodium stibogluconate, 4 with AmBisome and sodium stibogluconate and 12 with AmBisome alone. There were 13 (57%) spontaneous abortions in the sodium stibogluconate monotherapy group, and none in either of the other two groups. All spontaneous abortions occurred in the first two trimesters. All patients, except one in the sodium stibogluconate group who defaulted, were discharged as cured in good clinical condition. CONCLUSIONS: AmBisome treatment for VL appears to be safe and effective for pregnant women and their foetuses. We recommend the use of AmBisome as first-line treatment for these patients.
dc.language.isoenen
dc.publisherPublished by Oxford University Press
dc.relation.urlhttp://jac.oxfordjournals.org/cgi/content/full/58/4/811?ijkey=AUk/t.2Id5/xw&keytype=ref&siteid=jac
dc.rightsArchived on this site with kind permission from Oxford University Press and the British Society for Antimicrobial Chemotherapyen
dc.subject.meshAbortion, Spontaneousen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAmphotericin Ben
dc.subject.meshAnimalsen
dc.subject.meshAntimony Sodium Gluconateen
dc.subject.meshAntiprotozoal Agentsen
dc.subject.meshDrug Therapy, Combinationen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshInfant, Newbornen
dc.subject.meshLeishmaniasis, Visceralen
dc.subject.meshMiddle Ageden
dc.subject.meshPregnancyen
dc.subject.meshPregnancy Complications, Parasiticen
dc.subject.meshSudanen
dc.subject.meshTreatment Outcomeen
dc.titleA Comparison of Liposomal Amphotericin B with Sodium Stibogluconate for the Treatment of Visceral Leishmaniasis in Pregnancy in Sudan.en
dc.contributor.departmentMédecins sans Frontières, 67-74 Saffron Hill, London EC1N 8QX, UK.en
dc.identifier.journalThe Journal of Antimicrobial Chemotherapyen
html.description.abstractOBJECTIVES: Little is known about the treatment of visceral leishmaniasis (VL) in pregnancy, especially in resource-poor settings. We present a series of pregnant women with VL treated with either sodium stibogluconate or liposomal amphotericin B (AmBisome), or both, in eastern Sudan over 16 months. METHODS: We did a retrospective analysis of all pregnant VL patients treated in the Médecins sans Frontières (MSF) Um el Kher centre between January 2004 and April 2005. We diagnosed VL with laboratory confirmation of clinical suspects, and recorded the outcomes of treatment for pregnant women and their foetuses. We carried out a manual search of relevant publications and a systematic search of the literature in the MEDLINE database. RESULTS: We treated 23 women with sodium stibogluconate, 4 with AmBisome and sodium stibogluconate and 12 with AmBisome alone. There were 13 (57%) spontaneous abortions in the sodium stibogluconate monotherapy group, and none in either of the other two groups. All spontaneous abortions occurred in the first two trimesters. All patients, except one in the sodium stibogluconate group who defaulted, were discharged as cured in good clinical condition. CONCLUSIONS: AmBisome treatment for VL appears to be safe and effective for pregnant women and their foetuses. We recommend the use of AmBisome as first-line treatment for these patients.


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