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Liposomal amphotericin B + paromomycin sulfate is a combination therapy used primarily for the treatment of visceral leishmaniasis (VL) and post-kala-azar dermal leishmaniasis (PKDL). Liposomal amphotericin B is a lipid-based formulation of the polyene antifungal agent amphotericin B, which binds to ergosterol in the cell membranes of susceptible fungi and protozoa, leading to increased membrane permeability and cell death. Paromomycin sulfate is an aminoglycoside antibiotic that inhibits protein synthesis by binding to the 30S ribosomal subunit in prokaryotes and some protozoa, resulting in cell death. The combination leverages both drugs' antiparasitic effects for improved efficacy against Leishmania species. This regimen has been studied as a cost-effective alternative to monotherapy, with evidence supporting its use especially where drug resistance or toxicity limits other options[2][3][5].
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