13 Alternative systemic agents include aminosidine (paromomycin) pentamidine ketoconazole and itraconazole but they have yet to find a place in routine clinical practice.
Aminosidine (paromomycin) ointment (15% paromomycin 12% methyl benzethonium chloride in white soft paraffin) applied twice daily for 10 days are effective for L.
Kirby-Bauer antibiotic testing of Aeromonas species revealed antibiotic susceptibility to amikacin, aminosidine
, third-generation cephalosporins, second-generation quinolones, colistin, gentamicin, spectinomycin, trimethoprim-sulphonamides, and tetracycline.
Other drugs, such as sulphas, ketoconazole, allopurinol, aminosidine
and Amphotericin B are alternative therapies.
Cure at the end of follow up was achieved in 23 (77%), 28 (93%), and 29 (97%) patients with 12,16 and 20 mg aminosidine /kg/day respectively, and in 19 (63%) patients given sodium stibogluconate.
Treatment of visceral leishmaniasis (kalaazar) with aminosidine (paromomycin) antimonial combinations, a pilot study in Bihar, India.
Treatment of visceral leishmaniasis in Kenya by aminosidine alone or combined with sodium stibogluconate.
Aminosidine plus sodium stibogluconate for the treatment of Indian kala-azar: a randomized dose finding clinical trial.
A range of treatment options exists in visceral leishmaniasis, which include two pentavalent antimonials (meglumine antimoniate and sodium stibogluconate), four formulations of AmB, aminosidine
(paromomycin), pentamidine, and the new oral agent miltefosine (9,10).
pentavalent antimonials, amphotericin B, aminosidine
, or allopurinol) is not a practical control policy, not only because of the prohibitive cost involved but also because of high relapse rates (up to 74% ) among treated and clinically cured dogs.