Drug resistance in leishmaniasis


Croft, SL; Sundar, S; Fairlamb, AH; (2006) Drug resistance in leishmaniasis. Clinical microbiology reviews, 19 (1). 111-+. ISSN 0893-8512 DOI: 10.1128/CMR.19.1.111-126.2006

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Abstract

Leishmaniasis is a complex disease, with visceral and cutaneous manifestations, and is caused by over 15 different species of the protozoan parasite genus Leishmania. There are significant differences in the sensitivity of these species both to the standard drugs, for example, pentavalent antimonials and miltefosine, and those on clinical trial, for example, paromomycin. Over 60% of patients with visceral leishmaniasis in Bihar State, India, do not respond to treatment with pentavalent antimonials. This is now considered to be due to acquired resistance. Although this class of drugs has been used for over 60 years for leishmaniasis treatment, it is only in the past 2 years that the mechanisms of action and resistance have been identified, related to drug metabolism, thiol metabolism, and drug efflux. With the introduction of new therapies, including miltefosine in 2002 and paromomycin in 2005-2006, it is essential that there be a strategy to prevent the emergence of resistance to new drugs; combination therapy, monitoring of therapy, and improved diagnostics could play an essential role in this strategy.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Research Centre: Antimicrobial Resistance Centre (AMR)
Leishmaniasis Group
Neglected Tropical Diseases Network
PubMed ID: 16418526
Web of Science ID: 234822300007
URI: http://researchonline.lshtm.ac.uk/id/eprint/12087

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