Treatment of American tegumentary leishmaniasis in special populations: a summary of evidence
Rev. Soc. Bras. Med. Trop
;
46(6): 669-677, Nov-Dec/2013. tab, graf
Article
in English
| LILACS
| ID: lil-698068
ABSTRACT
We aimed to assess and synthesize the information available in the literature regarding the treatment of American tegumentary leishmaniasis in special populations. We searched MEDLINE (via PubMed), EMBASE, LILACS, SciELO, Scopus, Cochrane Library and mRCT databases to identify clinical trials and observational studies that assessed the pharmacological treatment of the following groups of patients pregnant women, nursing mothers, children, the elderly, individuals with chronic diseases and individuals with suppressed immune systems. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. The available evidence suggests that the treatments of choice for each population or disease entity are as follows nursing mothers and children (meglumine antimoniate or pentamidine), patients with renal disease (amphotericin B or miltefosine), patients with heart disease (amphotericin B, miltefosine or pentamidine), immunosuppressed patients (liposomal amphotericin), the elderly (meglumine antimoniate), pregnant women (amphotericin B) and patients with liver disease (no evidence available). The quality of evidence is low or very low for all groups. Accurate controlled studies are required to fill in the gaps in evidence for treatment in special populations. Post-marketing surveillance programs could also collect relevant information to guide treatment decision-making.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Leishmaniasis, Cutaneous
/
Evidence-Based Medicine
/
Antiprotozoal Agents
Type of study:
Etiology study
/
Practice guideline
/
Observational study
/
Prognostic study
/
Systematic reviews
Limits:
Aged
/
Child
/
Female
/
Humans
/
Pregnancy
Language:
English
Journal:
Rev. Soc. Bras. Med. Trop
Journal subject:
Tropical Medicine
Year:
2013
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade de Brasilia/BR
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