CHAPTER 30 LEISHMANIASIS: PROTOZOAN DERMATITIS 463
Base continued treatment on clinical improvement, identification of organisms in
repeat biopsies, and normalization of serum titers.
Relapses occur often within months to a year; recheck at least every 2 months after
completion of treatment.
Drugs of Choice
Meglumine antimoniate (100 mg/kg intravenously or subcutaneously q24h or divided
BID for 3–4 weeks).
Allopurinol (10 mg/kg PO BID): administered with pentavalent antimonials and for
long-term maintenance (Figure 30.7).
Miltefosine (2 mg/kg PO q24h).
Sodium stibogluconate (30–50 mg/kg intravenously or subcutaneously q24h for 3–
4 weeks): available in the United States through the Centers for Disease Control.
Alternative drugs include gamma-interferon, amphotericin-B, enrofloxacin, mar-
bofloxacin, metronidazole, and spiramycin.
Fig. 30.1.Exfoliative dermatitis of leishmaniasis: characteristic fine, silvery, and adherent scales on the head
of a 5-year-old female-spayed English pointer.