Leishmaniasis

During treatment

• Pentavalent antimonial compounds: clinical evaluation daily; ECG weekly or every 2 to 3 days if increased risk of cardiotoxicity; FBC, liver function tests (LFTs), renal function tests, blood potassium, and amylase/lipase tested weekly or on request.

• Amphotericin-B formulations: FBC, renal function tests, and blood electrolytes tested once or twice weekly.

• Miltefosine and paromomycin: renal function tests and LFTs taken weekly. With miltefosine use, monitor platelets and, in female patients, ensure a pregnancy test is negative and effective contraception is used at treatment initiation through 5 months after treatment.

• Pentamidine: ECG, FBC, LFTs, renal function tests, blood electrolytes, fasting blood glucose, and urinalysis before each dose.

After treatment

• Follow-up evaluation (clinical evaluation; additionally, in visceral leishmaniasis, check FBC and other laboratory tests as needed) at months 0, 1, 3, and 6 after treatment.

• Further follow-up evaluations every 3 to 6 months in immunosuppressed patients.

• Parasitological testing (e.g., smear, polymerase chain reaction) only if suspicion of non-response or relapse.

• Pentamidine: fasting blood glucose and urinalysis at 3 weeks and 2 to 3 months post treatment.