Treating pediatric cutaneous Leishmania tropica with systemic liposomal amphotericin B: A retrospective, single-center study.

Background Leishmania tropica (L. tropica) is associated with high morbidity and low response rate to therapy, especially in pediatric patients. Intravenous (IV) liposomal amphotericin B (LAmB) has been used off-label as a treatment for L. tropica CL for many years. However, data regarding its efficacy and safety in children are lacking. Objective To evaluate the efficacy and safety of IV LAmB for treating pediatric patients with L. tropica CL. Methods A retrospective single-center study of children diagnosed with L. tropica CL who were treated with IV LAmB during 2014-2020, at a tertiary medical center in Israel. Results Twenty-four patients were treated with IV LAmB. Fourteen (58%) completed the treatment protocol and 10 (42%) experienced an infusion-related adverse event (IRAE) leading to treatment termination. Complete response was noted in 6/14 (43%) patients, while 8/14 (57%) failed to respond. Lower response rate was noted in lesions involving the mid-facial area. Conclusion The relatively low response rate is speculated to result from a low dose of LAmB, short follow-up period, and difficult to treat anatomic locations. The observation of a lower response rate for mid-facial lesions should be validated in larger cohorts. The high risk of IRAE should be considered in physician decisions regarding this treatment. This article is protected by copyright. All rights reserved.