{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:06:30Z","timestamp":1790633190952,"version":"4.1.0"},"reference-count":27,"publisher":"FapUNIFESP (SciELO)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Soc. Bras. Med. Trop."],"published-print":{"date-parts":[[2002,12]]},"abstract":"<jats:p>Although treatment of visceral leishmaniasis with pentavalent antimony is usually successful, some patients require second-line drug therapy, most commonly with amphotericin B. To identify the clinical characteristics that predict an inadequate response to pentavalent antimony, a case-control study was undertaken in Teresina, Piaui, Brazil. Over a two-year period, there were 19 cases of VL in which the staff physicians of a hospital prescribed second-line therapy with amphotericin B after determining that treatment with pentavalent antimony had failed. The control group consisted of 97 patients that were successfully treated with pentavalent antimony. A chart review using univariate and multivariate analysis was performed. The cure rate was 90% with amphotericin B. The odds ratio for the prescription of amphotericin B was 10.2 for children less than one year old, compared with individuals aged over 10 years. Patients who presented coinfection had an OR of 7.1 while those on antibiotics had an OR of 2.8. These data support either undertaking a longer course of therapy with pentavalent antimony for children or using amphotericin B as a first-line agent for children and individuals with coinfections. It also suggests that chemoprophylaxis directed toward bacterial coinfection in small children with VL may be indicated.<\/jats:p>","DOI":"10.1590\/s0037-86822002000600014","type":"journal-article","created":{"date-parts":[[2005,4,26]],"date-time":"2005-04-26T16:49:43Z","timestamp":1114534183000},"page":"629-633","source":"Crossref","is-referenced-by-count":28,"title":["Predictors of an unsatisfactory response to pentavalent antimony in the treatment of American visceral leishmaniasis"],"prefix":"10.1590","volume":"35","author":[{"given":"M\u00e1cia A.","family":"Santos","sequence":"first","affiliation":[{"name":"Universidade Federal do Piau\u00ed"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayn\u00e9rio C.","family":"Marques","sequence":"additional","affiliation":[{"name":"Universidade Federal do Piau\u00ed"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolinne A.","family":"Farias","sequence":"additional","affiliation":[{"name":"Universidade Federal do Piau\u00ed"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle M.","family":"Vasconcelos","sequence":"additional","affiliation":[{"name":"Universidade Federal do Piau\u00ed"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay M.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Harvard Medical School, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorcas L.","family":"Costa","sequence":"additional","affiliation":[{"name":"Universidade Federal do Piau\u00ed"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos H.N.","family":"Costa","sequence":"additional","affiliation":[{"name":"Universidade Federal do Piau\u00ed"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1093\/infdis\/154.4.639","article-title":"A prospective study of visceral leishmaniasis in an endemic area of Brazil","volume":"154","author":"Badaro R","year":"1986","journal-title":"Journal Infection Disease"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1093\/clind\/24.4.684","article-title":"Human leishmaniasis: clinical, diagnostic, and chemotherapeutic developments in the last 10 years","volume":"24","author":"Berman JD","year":"1997","journal-title":"Clinical Infection Disease"},{"key":"ref3","series-title":"The leishmaniasis in biology and medicine","first-page":"848","volume-title":"Therapy in man","author":"Bryceson A","year":"1987"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"2066","DOI":"10.1172\/JCI112209","article-title":"Absence of gamma interferon and interleukin 2 production during active visceral leishmaniasis","volume":"76","author":"Carvalho EM","year":"1985","journal-title":"Journal Infection Investigation"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1128\/IAI.33.2.498-500.1981","article-title":"Cell-mediated immunity in American visceral leishmaniasis: reversible immunosuppression during acute infection","volume":"33","author":"Carvalho EM","year":"1981","journal-title":"Infection Immunity"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"475","DOI":"10.4269\/ajtmh.1983.32.475","article-title":"Quantitation of amastigotes of Leishmania donovani in smears of splenic aspirates from patients with visceral leishmaniasis","volume":"32","author":"Chulay JD","year":"1983","journal-title":"American Journal of Tropical Medicine and Hygiene","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9637","issn-type":"print"},{"key":"ref7","first-page":"361","article-title":"Epidemia de calazar no Estado do Piau\u00ed, Brasil","volume":"24","author":"Costa CHN","year":"1990","journal-title":"Revista de Sa\u00fade P\u00fablica","ISSN":"https:\/\/id.crossref.org\/issn\/0034-8910","issn-type":"print"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1086\/315795","article-title":"Competence of human host as reservoir for Leishmania chagasi","volume":"182","author":"Costa CHN","year":"2000","journal-title":"Journal of Infectious Disease"},{"key":"ref9","first-page":"360","article-title":"Treatment of malnutrition in refugee camps","volume":"342","author":"Golden MH","year":"1993","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0099-5355","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1056\/NEJM199912093412411","article-title":"Miltefosine - the long-awaited therapy for visceral leishmaniasis?","volume":"341","author":"Herwaldt BL","year":"1999","journal-title":"New England Journal of Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"296","DOI":"10.4269\/ajtmh.1992.46.296","article-title":"Recommendations for treating leishmaniasis with sodium stibogluconate (Pentostan) and review of pertinent clinical studies","volume":"46","author":"Herwaldt BL","year":"1992","journal-title":"American Journal Tropical Medicine and Hygiene"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/0035-9203(94)90393-X","article-title":"An urban outbreak of visceral leishmaniasis in Natal, Brazil","volume":"88","author":"Jeronimo SBM","year":"1994","journal-title":"Transaction Royal Society Tropical Medicine Hygiene"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1056\/NEJM199912093412403","article-title":"Miltefosine, an oral agent, for the treatment of Indian visceral leishmaniasis","volume":"341","author":"Jha TK","year":"1999","journal-title":"New England Journal of Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1128\/JCM.38.1.236-240.2000","article-title":"Optimized PCR using patient blood samples for diagnosis and follow-up of visceral leishmaniasis, with special reference to AIDS patients","volume":"38","author":"Lachaud L","year":"2000","journal-title":"Journal Clinical Microbiology"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1590\/S0037-86822001000600013","article-title":"QBC\u00ae for the diagnosis of human and canine American visceral leishmaniasis: preliminary data","volume":"34","author":"Liarte DB","year":"2001","journal-title":"Revista da Sociedade Brasileira de Medicina Tropical","ISSN":"https:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1016\/0140-6736(92)92952-C","article-title":"Amphotericin versus pentamidine in antimony-unresponsive kala-azar","volume":"340","author":"Mishra M","year":"1992","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0099-5355","issn-type":"print"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1016\/S0140-6736(94)90406-5","article-title":"Amphotericin versus sodium stibogluconate in first-line treatment in Indian kala-azar","volume":"344","author":"Mishra M","year":"1994","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0099-5355","issn-type":"print"},{"key":"ref18","first-page":"453","article-title":"Muttunga J: Is one year follow-up justified in kala-azar post-treatment?","volume":"71","author":"Nyakundi PM","year":"1994","journal-title":"East African Medical Journal","ISSN":"https:\/\/id.crossref.org\/issn\/0012-835X","issn-type":"print"},{"key":"ref19","first-page":"664","article-title":"Epidemic visceral leishmaniasis in Southern Sudan: treatment of severely debilitated patients under wartime conditions and with limited resources","volume":"124","author":"Seaman J","year":"1996","journal-title":"American College Physicians"},{"key":"ref20","first-page":"20","article-title":"Chemotherapy of leishmanial diseases: a resum\u00e9 of recent research","volume":"88","author":"Sen Gupta PC","year":"1953","journal-title":"Indiana Medicine Gazette"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1080\/00034983.1999.11813462","article-title":"Oral treatment of visceral leishmaniasis with miltefosine","volume":"93","author":"Sundar S","year":"1999","journal-title":"Annals of Tropical Medicine and Parasitology","ISSN":"https:\/\/id.crossref.org\/issn\/0003-4983","issn-type":"print"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1136\/bmj.296.6636.1557","article-title":"Rationalisation of regimens of treatment of kala-azar with sodium stibogluconate in India: a randomised study","volume":"296","author":"Thakur CP","year":"1988","journal-title":"British Medicine Journal"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"435","DOI":"10.4269\/ajtmh.1991.45.435","article-title":"Comparison of regimes of treatment of antimony-resistant kala-azar patients: a randomized study","volume":"45","author":"Thakur CP","year":"1991","journal-title":"American Journal of Tropical Medicine and Hygiene","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9637","issn-type":"print"},{"key":"ref24","first-page":"170","article-title":"Evaluation of amphotericin B as a first-line drug in comparison to sodium stibogluconate in the treatment of fresh cases of kala-azar","volume":"97","author":"Thakur CP","year":"1993","journal-title":"Indiana Journal Medical Research"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/BF02860503","article-title":"Efficacy of amphotericin B in multi-drug resistant kala-azar in children in first decade of life","volume":"60","author":"Thakur CP","year":"1993","journal-title":"Indian Journal of Pediatrics","ISSN":"https:\/\/id.crossref.org\/issn\/0019-5456","issn-type":"print"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/S0035-9203(99)90037-8","article-title":"Amphotericin B deoxycholate treatment of visceral leishmaniasis with newer modes of administration and precautions: a study of 938 cases","volume":"93","author":"Thakur CP","year":"1999","journal-title":"Transaction Royal Society Tropical Medicine Hygiene"},{"key":"ref27","series-title":"Control of the leishmaniasis","year":"1990"}],"container-title":["Revista da Sociedade Brasileira de Medicina Tropical"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/rsbmt\/v35n6\/a14.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T21:26:42Z","timestamp":1625866002000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0037-86822002000600014&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,12]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2002,12]]}},"alternative-id":["S0037-86822002000600014"],"URL":"https:\/\/doi.org\/10.1590\/s0037-86822002000600014","relation":{},"ISSN":["0037-8682"],"issn-type":[{"value":"0037-8682","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,12]]}}}