{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T12:43:21Z","timestamp":1789389801718,"version":"build-2803163510"},"reference-count":16,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,10,9]]},"abstract":"<jats:p>Promastigote miltefosine (MIL) susceptibility was performed on <jats:italic>Leishmania donovani<\/jats:italic> isolates from Indian patients with visceral leishmaniasis treated with MIL. Isolates that were obtained before the onset of MIL treatment, after completion of treatment (29th day), or at the time of treatment failure, were screened using <jats:italic>in vitro<\/jats:italic> promastigote assay. The MIL susceptibility of the pre-treatment isolates (<jats:italic>N<\/jats:italic> = 24, mean IC<jats:sub>50<\/jats:sub> \u00b1 SEM = 3.74 \u00b1 0.38 \u03bcM) was significantly higher than that of the post-treatment group (<jats:italic>N<\/jats:italic> = 26, mean IC<jats:sub>50<\/jats:sub> \u00b1 SEM = 6.15 \u00b1 0.52 \u03bcM; <jats:italic>P<\/jats:italic> = 0.0006) but was similar in the cured patients (<jats:italic>N<\/jats:italic> = 22, mean IC<jats:sub>50<\/jats:sub> \u00b1 SEM = 5.58 \u00b1 0.56 \u03bcM) and those who failed treatment (<jats:italic>N<\/jats:italic> = 28, mean IC<jats:sub>50<\/jats:sub> \u00b1 SEM = 4.53 \u00b1 0.47 \u03bcM). The pre\/post-treatment results thus showed a 2-fold difference, whereas isolated from cured versus failed patients showed a similar susceptibility, suggesting that this higher tolerance is not responsible for MIL-treatment failure. Our work highlights the need for careful monitoring of MIL susceptibility for implementation in national VL elimination programs.<\/jats:p>","DOI":"10.4269\/ajtmh.13-0096","type":"journal-article","created":{"date-parts":[[2013,8,27]],"date-time":"2013-08-27T03:40:00Z","timestamp":1377574800000},"page":"750-754","source":"Crossref","is-referenced-by-count":44,"title":["In vitro Susceptibility of Leishmania donovani to Miltefosine in Indian Visceral Leishmaniasis"],"prefix":"10.4269","volume":"89","author":[{"given":"Vijay Kumar","family":"Prajapati","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smriti","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhukar","family":"Rai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Ostyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poonam","family":"Salotra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manu","family":"Vanaerschot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Claude","family":"Dujardin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyam","family":"Sundar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"PLoS 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nanotubes","volume":"66","author":"Prajapati","year":"2011"},{"key":"R6","series-title":"N Engl J Med","first-page":"1739","article-title":"Oral miltefosine for Indian visceral leishmaniasis","volume":"347","author":"Sundar","year":"2002"},{"key":"R7","series-title":"N Engl J Med","first-page":"1795","article-title":"Miltefosine, an oral agent, for the treatment of Indian visceral leishmaniasis","volume":"341","author":"Jha","year":"1999"},{"key":"R8","series-title":"Clin Infect Dis","first-page":"543","article-title":"Efficacy of miltefosine in the treatment of visceral leishmaniasis in India after a decade of use","volume":"55","author":"Sundar","year":"2012"},{"key":"R9","series-title":"Clin Infect Dis","first-page":"1530","article-title":"Increasing failure of Miltefosine in the treatment of kala-azar in Nepal and the potential role of parasite drug resistance, reinfection, or noncompliance","volume":"56","author":"Rijal","year":"2013"},{"key":"R10","series-title":"Antimicrob 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