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The Challenges of Effective Leishmaniasis Treatment

  • Sarah Hendrickx
  • Louis Maes
  • Simon L. Croft
  • Guy Caljon
Chapter

Abstract

During the past decades, visceral leishmaniasis therapy has been faced with the rapid emergence of drug resistance against the pentavalent antimonials which had been used as mainstay of treatment for over 70 years. Even though cutaneous leishmaniasis cannot be linked to development of drug resistance, the huge species- and strain-specific variations in drug susceptibilities severely complicate effective treatment as well. A new challenge in leishmaniasis control has arisen with increasing numbers of treatment failures against all of the currently used anti-leishmanial standard drugs. The exact causes of these treatment failures are still not fully comprehended, but they are most likely a consequence of the complex interplay between parasite, host and drug. In this chapter, the generally accepted underlying factors of treatment failure are discussed along with their consequences for therapy, drug design and other related challenges.

Keywords

Drug susceptibility Treatment failure/relapse PK-PD In vivo sanctuary sites Parasite-drug-host interaction 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Sarah Hendrickx
    • 1
  • Louis Maes
    • 1
  • Simon L. Croft
    • 2
  • Guy Caljon
    • 1
  1. 1.Laboratory for Microbiology, Parasitology and Hygiene (LMPH)University of AntwerpWilrijk (Antwerp)Belgium
  2. 2.Department of Immunology and Infection, Faculty of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUK

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