What is the recommended dose of itraconazole (antifungal medication) for the treatment of leishmaniasis in a 13-year-old female child weighing 44 kilograms?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Article Review Status
Submitted
Under Review
Approved

Last updated: March 16, 2025 • View editorial policy

From the Research

Itraconazole is not a first-line treatment for leishmaniasis in children, and its use should be considered only after consultation with an infectious disease specialist due to its limited efficacy and potential for hepatotoxicity. For a 13-year-old female weighing 44 kg with leishmaniasis, the recommended treatments would instead be liposomal amphotericin B (3-5 mg/kg/day for 3-5 days), pentavalent antimonials (20 mg/kg/day for 20-30 days), or miltefosine (2.5 mg/kg/day for 28 days) 1.

Key Considerations

  • The most effective treatment for leishmaniasis is liposomal amphotericin B, which has been shown to be virtually 100% effective for Indian visceral disease at a total dose of 15 mg/kg and is 90% effective at a dose of 5-10 mg/kg 1.
  • Miltefosine is also an effective oral agent, with a cure rate of more than 95% for Indian visceral disease 1.
  • Itraconazole has shown limited efficacy against leishmaniasis and is generally not included in standard treatment protocols, but if used, the dose would typically be 5-8 mg/kg/day (approximately 200-300 mg daily for this patient) divided into two doses for 4-6 weeks, taken with food to enhance absorption 2.

Monitoring and Precautions

  • Treatment with itraconazole should include regular monitoring of liver function tests, as it can cause hepatotoxicity.
  • The patient should also be monitored for clinical improvement and potential drug interactions, as itraconazole affects the metabolism of many medications through the cytochrome P450 system.
  • Fluconazole has been shown to be effective in treating cutaneous leishmaniasis, particularly in cases caused by Leishmania major, with a dose of 6 mg/kg/day for 6 weeks 3.

Conclusion is not allowed, so the answer will be ended here.

References

Research

Current treatment approaches to leishmaniasis.

Current opinion in infectious diseases, 2003

Research

Cutaneous leishmaniasis: successful treatment with itraconazole.

International journal of dermatology, 2006

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.