Failure of pentavalent antimony in visceral leishmaniasis in India: report from the center of the Indian epidemic.

By S. Sundar, Deepa More, M. Singh, Vijay Singh, Sashi Sharma, Anand Makharia, Prasanna Kumar, H. Murray. Clinical Infectious Diseases, 2000

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Visceral leishmaniasis: what are the needs for diagnosis, treatment and control? (2007, background): “Conventional amphotericin B has replaced antimonials as the first-line treatment for VL in some areas of the Bihar State of India where treatment failure rates for antimonials reached >60% (Ref”
The Relationship between Leishmaniasis and AIDS: the Second 10 Years (2008, background): “Injectable pentavalent antimonials (sodium stibogluconate and meglumine antimoniate) (Table 4) have remained the mainstream treatment for VL since their introduction in the 1940s and are still highly effective, except in regions in India (Bihar) and Nepal, where resistance has rendered them almost u”
Drug Resistance in Leishmaniasis (2006, neutral): “Even in this geographical region a variation in Sb(V) sensitivity occurs with significant drug resistance at the epicenter of the epidemic and a high level of sensitivity only 200 miles away (144).”
Drug resistance in Indian visceral leishmaniasis (2001, background): “More than 100 000 cases of VL occur in India alone every year, and state of Bihar accounts for more than 90% of these (Bora 1999; Sundar et al. 2000a,b).”