[Leish-l] Warning: Drugs for human leishmaniasis used to treat dogs

[Carlos Costa]

What are the pieces of evidence that treating dogs with SbV and miltefosine
leads to resistance of L. infantum in humans?

On Thu, Dec 5, 2019 at 12:01 PM Rolando Oddone <roloddone at googlemail.com>
wrote:

> Yes, Dr Kwang-Poo Chang. The position of health authorities and PAHO
> officials (at least in Paraguay) is to restrict the use of these drugs only
> for human cases. The reason is obvious. As the Leishmania are not totally
> killed by these drugs during treatment, they are creating resistance
> against these same drugs. Similar situation ocurred in India during the
> 1990's, with indiscriminate use of antimonials in humans. In some regions
> of India, nearly 50% of VL cases (caused by L. donovani) were found
> resistant to SbV, therefore WHO speeded up the use of Miltefosine as
> alternative drug. But in our case, Miltefosine is not as useful as in
> India. It can cure VL cases (in Paraguay caused by L. infantum) but they
> easily relapse.
>
> The conclusions of the last WorldLeish in Spain were clear: there are no
> new drugs for leishmaniasis. If we are creating resistance of Leishmania
> against SbV, we will have very few options for all human cases. But if dogs
> do not use antimonials, they can be treated by other drugs, as far as I
> understand.
>
>
> Rolando Oddone
>
>
> El mar., 5 de nov. de 2019 a la(s) 17:13, Kwang-Poo Chang (
> kwangpoo.chang at rosalindfranklin.edu) escribió:
>
> > Dear Rolando,
> >
> > Both drugs you mentioned have been used by veterinarians elsewhere for
> > treating canine leishmaniasis, although neither has been shown to cure
> the
> > disease. According to my colleagues in Naples, Italy, the diseased dogs
> > responded positively to the treatment when used at high dosage initially,
> > as indicated by a reduction of LD loads and alleviation of clinical
> > symptoms, but ~50% of them died of flare-ups eventually. Your concern
> seems
> > to be a regulatory issue of restricting the use of these drugs only for
> > human cases in Paraguy ?
> >
> > Laura Manna is a DVM in Naples who has been trying our
> > photodynamically inactivated Leishmaina as non-viable whole-cell vaccines
> > for immunotherapy of canine leishmaniasis after initial chemotherapy with
> > evidence of some effectiveness. Let me know, should you or your
> colleagues
> > are interested in this ?
> >
> > KP
> >
> > Kwang Poo Chang, PhD
> > Professor of Microbiology/Immunology
> > Chicago Medical School/RFUMS
> > N Chicago, IL 60064, USA
> >
> > On Fri, Nov 1, 2019 at 4:40 PM Rolando Oddone <roloddone at googlemail.com>
> > wrote:
> >
> >> In Paraguay we have growing proliferation of dogs with leishmaniasis (L.
> >> infantum) since the 1990s.
> >> But dog owners with leishmaniasis are increasingly reluctant to
> sacrifice
> >> their animals. In recent years Glucantime and Milteforan are entering
> the
> >> country smuggled (apparently they come from France and Spain), for
> "free"
> >> use in dogs. These medications are currently being used indiscriminately
> >> by
> >> veterinarians who, for profit, take advantage of the need that people
> have
> >> to want to preserve the lives of their pets.
> >> Under this scenario, hundreds of dogs have already been treated with
> these
> >> drugs, perhaps a thousand in a few years, and the magnitude of the
> problem
> >> will increase.
> >> However, the authorities of the Ministry of Health do not take any
> >> measures, despite the existence of recommendations that these drugs are
> >> exclusively for human use.
> >> The purpose of this sharing is, dear colleagues, that you express your
> >> position regarding this situation, at least in this way, and what would
> be
> >> the impact this could have at the international level. Your joint voice
> >> will be better heard than the simple complaint I may make.
> >>
> >>
> >> Rolando Oddone
> >> IICS-UNA
> >> Paraguay
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-- 
Carlos H. N. Costa, MD, DSc.
President
Instituto de Doenças do Sertão
*Instituto de Doenças Tropicais Natan Portella*

*Centro de Ciências da Saúde da Universidade Federal do Piauí*
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*Brazil*
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