Pentavalent antimonial

Pentavalent antimonials (also abbreviated pentavalent Sb or SbV) are a group of compounds used for the treatment of leishmaniasis. They are also called pentavalent antimony compounds.

Types

The first pentavalent antimonial, urea stibamine, was synthesised by the Indian scientist Upendranath Brahmachari in 1922. Though it caused a dramatic decline in deaths due to leishmaniasis, it fell out of favour in the 1950s due to higher toxicity compared to sodium stibogluconate.

The compounds currently available for clinical use are:

  • sodium stibogluconate (Pentostam; manufactured by GlaxoSmithKline; available in United States [through the Centers for Disease Control only] and UK), which is administered by slow intravenous injection.
  • meglumine antimoniate (Glucantim; manufactured by Aventis; available in Brazil, France and Italy), which is administered by intramuscular or intravenous injection.[1]

The pentavalent antimonials can only be given by injection: there are no oral preparations available.

Alternatives

In many countries, widespread resistance to antimony has meant that amphotericin or miltefosine are now used in preference.[2]

Side effects

Cardiotoxicity, reversible kidney failure, pancreatitis, anemia, leukopenia, rash, headache, abdominal pain, nausea, vomiting, arthralgia, myalgia, thrombocytopenia, and transaminase elevation.

References
  1. Lima EB, Porto C, Motta JCO, Sampaio RNR.Treatment of American cutaneous leishmaniasis. An Bras Dermatol. 2007;82(2):111-24.
  2. Olliaro P, Guerin P, Gerstl S (2005). "Treatment options for visceral leishmaniasis: a systematic review of clinical studies done in India, 1980–2004". Lancet Infect Dis. 5 (12): 763–774. doi:10.1016/S1473-3099(05)70296-6. hdl:10144/66036. PMID 16310148.


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