Clinicoepidemiological study of drug resistance in Indian kala - azar

Abstract

Large scale therapeutic failure of antimony has been the outstanding feature of the current epidemic of Indian kala - azar. Because of the ineffectiveness of a regimen of sodium stibogluconate 10 mg/kg body weight for 6-10 days the World Health Organisation recommended a dosage of 20 mg/kg body weight for 20 days in new cases and for 40 days in relapses.1 Initial successes achieved with these regimens, however, have not been sustained.2,3 Against this background we examined the clinicoepidemiological factors contributing to the unresponsiveness of Indian kala-azar to the drug. We studied 312 patients with Indian kala-azar (proved parasitologically) who had received one or more courses of antimony but had failed to recover. The mean weight of these patients was 38.8 (SD 13.3) kg; 169 patients weighed more than …