The MSF said that the problem has been caused by a monopoly by Gilead Sciences, a pharmaceutical firm that has failed to deliver on promises to make the drug available to people suffering from HIV.Last year, Gilead announced its 'access initiative' promising lower prices for liposomal amphotericin
B (L-AMB) in 116 developing countries, Kenya included but to date, the drug largely remains inaccessible and unavailable at an affordable price in Kenya.
All isolates were markedly resistant to fluconazole, and [approximately equal to]40% were resistant to liposomal amphotericin
B (Appendix Figure).
strains and protect red blood cells from amphotericin
B can be given for a longer period and at higher doses in immunocompromised patients to prevent recurrence of kala-azar.
While intrathecal amphotericin
B was previously the standard treatment, it is now reserved for the more severe or refractory cases or the first trimester of pregnancy .
Emerging evidence from an ongoing trial suggests that weight based oral fluconazole dose of 1600mg is more effective than the current WHO recommended dose (1200mg) and safer than 2000mg but less effective than amphotericin
B across all doses .
This class consists of a single agent, amphotericin
50 mg/kg/ antibiotics Amphotericin
B and 0.7 mg/day flucytosine
Results: Biochemical and histopathological analysis showed significant kidney injury in rabbits exposed to acute nephrotoxic doses of amphotericin
B and cyclosporine.
The susceptibility profile showed 89% sensitivity to fluconazole, 98% to voriconazole, 87% to caspofungin, 94% to micafungin, 77% to amphotericin
B, and 81% to 5-flucytosine.
He was again switched to amphotericin
at the dosage of 0.7 mg/kg/day for another one month but during this period he again developed amphotericin