New developments in the chemotherapy of leishmaniasis.

Several significant advances in the chemotherapy of leishmaniasis have occurred in the last 10 years. Some of these advances have arisen due to the greater awareness of the pharmacokinetic properties of drugs, such as the pentavalent antimonials, while others have resulted from the introduction of drugs new to the treatment of leishmaniasis, such as aminosidine which can be used both systemically and topically against cutaneous leishmaniasis. The most encouraging advance is the use of lipid-associated amphotericin B; very short treatments with these preparations have been shown to be effective. Other studies have shown the usefulness of combination therapy and the use of immune modulators. A number of biochemical pathways in Leishmania, such as those associated with purine and sterol metabolism, are known to be distinct from those of the mammalian hosts. These have been exploited in the search for the rational choice of anti-leishmanial agents.