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June 1993

Treatment of Visceral Leishmaniasis With Meglumine and Allopurinol-Reply

Author Affiliations

Department of Pediatrics Hematology Unit Faculty of Medicine Hacettepe University Hacettepe Children's Hospital Ankara 06100, Turkey

Am J Dis Child. 1993;147(6):612. doi:10.1001/archpedi.1993.02160300018012

In Reply.—I thank Ragusa et al for supporting our findings that meglumine antimoniate is generally effective in the treatment of visceral leishmaniasis if it is given in appropriate doses. They used 100 mg/kg per day for 3 to 4 weeks and we used 60 mg/kg per day for 2 weeks to test individual hypersensitivity in the first week of the treatment.1 These doses are much higher than the doses used by others2-4 (10 to 20 mg/kg per day) who did not obtain such good results.

The patients of Ragusa et al were admitted "in satisfactory clinical condition," unlike our patients with visceral leishmaniasis, most of whom were mildly or severely malnourished. This difference should be taken into consideration for comparison of treatment results.

Addition of allopurinol to meglumine antimoniate administration in leishmaniasis treatment has strong support because Leishmania cannot synthesize the purine ring in its infective stage and depends