Open Access
Review
Table 2
Combination therapies for human leishmaniases.
| Combination treatments | Advantages | Region | Leishmania species | References | |
|---|---|---|---|---|---|
| Human VL | |||||
| SSG (IV/IM, 20 mg/kg, 17 d) | Paromomycin (IM, 15 mg/kg, 17 days) | Treatment reduction time from 30 to 17 days. Reduced hospitalization. | Eastern Africa | L. donovani and L. infantum | [37] |
| L-AMB (IV, 5 mg/kg, single dose) | Miltefosine (O, 50–100 mg/day, 7 days) or paromomycin (IM, 11 mg/kg/day, 10 days) | Reduction from 15 mg/kg total over 30 days to a single injection of 5 mg/kg. Fewer adverse events and reduction of treatment time (31 to 15 days). | India | [37] | |
| Miltefosine (O, 50–100 mg/day, 10 d) | Paromomycin (IM, 11 mg/kg/day, 10 days) | ||||
| L-AMB (IV, 10 mg/kg, single dose) | SSG (IM, 20 mg/kg/day, 10 d) or miltefosine (O, 2.5 mg/kg/day, 10 days) | Efficacy <90% cure in phase II, no phase III trial. | Eastern Africa | L. donovani | [109] |
| L-AMB (IV, 30 mg/kg total, 5 mg/kg/d on alternate days) | Miltefosine (O, 100 mg/day, 28 days) | Increased efficacy compared to monotherapy at 40 mg/kg as recommended by the WHO; highest documented efficacy in HIV+/VL patients. | Ethiopia | [26] | |
| Human L. braziliensis | |||||
| Miltefosine (O, 150 mg/day, 28 days) | Pentamidine (IL, 120 μg/mm2 lesion area on alternate days for 3 days) | Additive effect, fewer adverse effects, and reduced cost. Alternative for local treatment, dissemination prevention, or when avoiding parenteral administration. | Bolivia | L. braziliensis | [93] |
| Human CL | |||||
| Glucantime (IL, 1 mL/cm2 of lesion, 1×/week, 6 weeks) | Itraconazole (O, 200 mg/day, 6 weeks) | No benefit on efficacy or treatment duration compared to Glucantime® alone. | Pakistan | Cutaneous leishmaniasis | [8] |
IV: intravenous; IM: intramuscular O: oral; IL: intralesional.
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