A comparison of three dosage regimens of sodium stibogluconate in the treatment of visceral leishmaniasis in Kenya

A prospective randomized trial of three dosage regimens of sodium stibogluconate (PentostamR; Wellcome Foundation, London) to treat visceral leishmaniasis was conducted. Previously untreated patients were randomized to receive 31 doses of sodium stibogluconate (10 mg Sb/kg of body weight per dose) administered once daily for 31 days (group A), every 12 hr for 15 days (group B), or every 8 hr for 10 days (group C). Of the 29 patients who completed treatment, seven of 10 in group B and all of the patients in groups A and C responded to treatment and remained well for one year. One patient in group B failed to respond to treatment, and two others in group B initially responded to treatment but relapsed six weeks after discharge. None of the treatment regimens was toxic. Parasites disappeared from splenic aspirates most quickly and hemoglobin levels rose most rapidly in patients receiving sodium stibogluconate every 8 hr. Treatment of visceral leishmaniasis in Kenya with sodium stibogluconate at a dose of 10 mg Sb/kg every 8 hr for 10 days appears to be a safe alternative to conventional treatment. Its efficacy should be confirmed in a larger number of patients. Visceral leishmaniasis is a chronic infectious disease caused by the protozoan parasite Leishmania donovani, is transmitted by phlebotomine sandflies, and is characterized by splenomegaly, anemia, fever, weight loss, malnutrition, immune