Paromomycin.

Abstract

Paromomycin is an aminoglycoside that is active against Gram-negative and many Gram-positive bacteria as well as some protozoa and cestodes. It is out of use as an antibiotic but was licensed in 2007 in India as an effective, well tolerated and affordable treatment for visceral leishmaniasis (VL) at a dose of 11 mg/kg (base) for 21 days. Currently, the non-profit group Drugs for Neglected Diseases Initiative is conducting studies on paromomycin (as monotherapy and in combination) in VL in Africa, and the Institute for OneWorld Health is conducting a Phase IV study in India. Paromomycin in combination with sodium stibogluconate has proven to be effective in African and Indian VL and improves survival in African VL. To prevent the emergence of drug-resistant leishmaniasis in areas of anthroponotic transmission (India and Africa), paromomycin should be used as part of combination therapy for VL. Further trials testing different combinations are much needed. In addition, the distribution of paromomycin (like other drugs for leishmaniasis) should be well regulated and preferably restricted to the public sector. These strategies should ensure the longevity of paromomycin as a useful drug for VL.

• Authors: Robert N Davidson, Margriet den Boer, Koert Ritmeijer
• Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene (Trans R Soc Trop Med Hyg) Vol. 103 Issue 7 Pg. 653-60 (Jul 2009) ISSN: 1878-3503 [Electronic] England
• PMID: 18947845 (Publication Type: Journal Article, Review)

Chemical References

• Anti-Bacterial Agents
• Antiprotozoal Agents
• Paromomycin

Topics

• Animals
• Anti-Bacterial Agents (therapeutic use)
• Antiprotozoal Agents (pharmacokinetics, therapeutic use)
• Communicable Diseases, Emerging (prevention & control)
• Drug Resistance
• Humans
• Leishmaniasis, Visceral (drug therapy, prevention & control)
• Paromomycin (pharmacokinetics, therapeutic use)