miltefosine + antimony

Miltefosine + antimony is a combination therapy used primarily for the treatment of cutaneous leishmaniasis. Miltefosine is an oral alkylphosphocholine originally developed as an anticancer agent and later repurposed for leishmaniasis due to its antiparasitic activity. It acts by interfering with cell membrane integrity and lipid metabolism in Leishmania parasites, leading to parasite death. Antimony refers to pentavalent antimonial drugs such as sodium stibogluconate or meglumine antimoniate, which have been first-line treatments for leishmaniasis for decades; they act by inhibiting key enzymes in parasite energy metabolism and inducing oxidative stress within the parasite. The combination aims to improve efficacy, reduce treatment duration, lower toxicity compared to full courses of either drug alone, and potentially delay or prevent resistance development[2][6]. This approach leverages different mechanisms of action from each component.