Dear DSFL cruncher

Amphotericin B is a drug that have been used as a second choice for the Leishmaniasis treatment in many endemic areas and with good efficay. Initially, it was administered parenterally in those patients that did not respond to the antimonials. However, it could caused severe side effects and other times it was contraindicated for certain patients. Then it was encapsulated in liposomes (a lipid bag) and the severe side effect diminished, but it was expensive. Currently, the company manufacturing this presentation cut the price and it uses as antileishmania agent have been extended. However, in spite of it decrease in toxicity and price, in this liposome presentation, the administration have to be parenteral.
It is good to know that promising studies to administer amphotericin B orally are in course at least for Visceral Leishmaniasis, which is mainly caused by two Leishmania species (Leishamnia donovani and Leishmania infantum).

We have been testing an ointment presentation of amphotericin B, with also promising results, obviously for cutaneous leishmaniasis which are approximately 1.5 million cases per year.

But why to continue searching for new drugs??. Among several reason are:
1. The number of alternative options are few. We need more or alternative options
2. The efficacy of the current drugs (included amphotericin B) can be variable depend on the Leishmania species (there are more than 20 Leishmania species associated with disease in human).
3. Development of parasite resistance when administration of amphotericin B is authorized in most endemic countries as first option, is a probability. We have to be prepared to face it.
4. The administration of amphotericin B may be contraindicated in some patients with particular condition.
5. And why to administer a systemic drug with some toxicity for treating a cutaneous ulcer?.
6. Cost may be also a reason given Leishmaniasis is mostly endemic in poor countries or affecting poor communities.
There are even more reason.

Best wishes