Title: Comparison of Toxicity of Intravenous Amphotericin B in Diagnosed Cases of Kala Azar on Daily versus Alternate Day Regimen
Authors: Jyoti Kumar Dinkar, Naresh Kumar, Binod Kumar Choudhary, Ashok Shanker Singh
DOI: https://dx.doi.org/10.18535/jmscr/v5i10.22
Abstract
Introduction: Kala- azar (visceral leishmaniasis) is a disease caused by unicellular eukaryotic obligatory intracellular protozoa of the genus Leishmania and primarily affects the host’s reticuloendothelial system. The organisms are transmitted by phlebotomine sandflies of the genus phlebotomus. Amphotericin B deoxycholate is first line drug treatment of kala-azar in endemic regions of Bihar and given as 15 alternate day infusion in a dose of 1 mg/kg over 30 days; however daily regimen of 1 mg/kg can also be used over 15 days. The aim and objectives of the study is to compare the toxicity of intravenous Amphotericin B if any, in diagnosed cases of kala-azar on daily versus alternate day regimen.
Materials and Methods: The present study was conducted on 60 freshly diagnosed cases of kala-azar. All patients above 10 years of age of either gender with a diagnosis of kala-azar were included in the study. They were divided randomly in two groups each having 30 patients. Group A patients received AMB in a dose of 1mg/kg for 15 infusions over 15 days while Group B patients received it in a dose of 1mg/kg as 15 alternate day infusion over 30 days. The results of various parameters were recorded during treatment and then weekly to assess the response of therapy. The pretreatment record of investigations formed the basis of reference of toxicities, if any.
Results: Out of 60 cases of kala-azar 37(61.66%) were male and 23(38.33%) were female. 66.66% of total kala-azar patients were young and found in the age group of 11-30 years. The characteristics like average weight gain, the regression of size of spleen and liver, haemoglobin and total leucocyte count were found to be significant (p value<0.05) in both treatment groups.
Conclusion: The results of the study reveals that daily regimen of Amphotericin B in a dose of 1 mg/kg body weight can be given safely to kala-azar patients and this regimen cannot only lessens the financial burden of the patients but can also minimizes the hospital stay.
Keywords: kala-azar, Amphotericin B, Alternate day, Daily, Regimen, Toxicity.
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