Pharmacotherapy in leishmaniasis: old, new treatments, their impacts and expert opinion

Leishmaniasis is caused by protozoan parasites of the genus Leishmania. An estimated 20 different Leishmania species, each with a particular drug response, are associated with three main clinical disease: cutaneous (CL), mucosal (ML) and visceral leishmaniasis (VL). Today, more than 1 billion people live in leishmaniasis-endemic areas and are at risk of infection. It is estimated that there are between 50,000–90,000 VL and 600,000–1 million new CL cases annually [1,2]. In the Americas, among an annual mean of 55,317 leishmaniasis cases, 72.6% occurred in Brazil. The incidence of ML was 3.78% [3]. VL kills more people than any other parasitic disease except malaria [4]. Patients will die without treatment (20,000–30,000 deaths annually) [4], and ML patients can also die, usually due to bacterial infection [5].