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

[Rolando Oddone]

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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