{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T23:28:44Z","timestamp":1776986924753,"version":"3.51.4"},"reference-count":25,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,10,3]]},"abstract":"<jats:p>Regional variations in susceptibility of <jats:italic>Leishmania donovani<\/jats:italic> clinical isolates have been reported to antimonials but not other antileishmanial drugs. Therefore, we evaluated the susceptibility of four antileishmanial drugs in clinical use in 28 clinical isolates from endemic and non-endemic regions in the J774A.1 macrophage cell line, and we found increased tolerance of miltefosine and paromomycin in isolates from a patient from a high endemic region. Effective dose for 90% killing (ED<jats:sub>90<\/jats:sub>) values were significantly higher for miltefosine (<jats:italic>P<\/jats:italic> = 0.005) and paromomycin (<jats:italic>P<\/jats:italic> = 0.02) in isolates from the high endemic region, although there were no significant differences between ED<jats:sub>50<\/jats:sub> values for paromomycin, miltefosine, and amphotericin B in the non- versus endemic region isolates. This report is the first of higher ED<jats:sub>90<\/jats:sub> values for miltefosine and paromomycin indicating susceptibility difference between regions for these newly introduced drugs by the parasite, and their use should be carefully monitored through directly observed therapy or multidrug treatment to preserve their efficacy for longer periods.<\/jats:p>","DOI":"10.4269\/ajtmh.2012.12-0022","type":"journal-article","created":{"date-parts":[[2012,9,21]],"date-time":"2012-09-21T15:15:22Z","timestamp":1348240522000},"page":"655-657","source":"Crossref","is-referenced-by-count":24,"title":["In vitro Antileishmanial Drug Susceptibility of Clinical Isolates from Patients with Indian Visceral Leishmaniasis\u2014Status of Newly Introduced Drugs"],"prefix":"10.4269","volume":"87","author":[{"given":"Vijay Kumar","family":"Prajapati","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjana","family":"Mehrotra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalini","family":"Gautam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhukar","family":"Rai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyam","family":"Sundar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Lancet Infect Dis","first-page":"494","article-title":"Visceral leishmaniasis: current status of control, diagnosis, and treatment, and a proposed research and development agenda","volume":"2","author":"Guerin","year":"2002"},{"key":"R2","series-title":"Trop Med Int 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resistance to amphotericin B in visceral leishmaniasis in a region in India where leishmaniasis is not endemic","volume":"49","author":"Srivastava","year":"2011"},{"key":"R20","series-title":"Antimicrob Agents Chemother","first-page":"835","article-title":"In vitro susceptibility of field isolates of Leishmania donovani to Miltefosine and amphotericin B: correlation with sodium antimony gluconate susceptibility and implications for treatment in areas of endemicity","volume":"53","author":"Kumar","year":"2009"},{"key":"R21","series-title":"Drug Resist Updat","first-page":"26","article-title":"Mechanisms of experimental resistance of Leishmania to miltefosine: implications for clinical use","volume":"9","author":"Perez-Victoria","year":"2006"},{"key":"R22","series-title":"Bull World Health Organ","first-page":"394","article-title":"Availability of miltefosine for the treatment of kala-azar in India","volume":"83","author":"Sundar","year":"2005"},{"key":"R23","series-title":"Control of 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