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The sodium stibogluconate + paromomycin combination is a treatment regimen used primarily for visceral leishmaniasis (VL), particularly in East Africa. This combination therapy consists of sodium stibogluconate (SSG) administered at 20 mg/kg/day and paromomycin (PM) at 15 mg/kg/day for 17 days. ## Efficacy and Safety Clinical trials have demonstrated that the SSG + PM combination has comparable efficacy to the standard 30-day SSG monotherapy treatment for visceral leishmaniasis. In a multi-center randomized controlled trial conducted in East Africa, the efficacy of the combination therapy was 91.4% compared to 93.9% for SSG alone, with no significant difference between the two treatments (difference = 2.5%, 95% CI: -1.3 to 6.3%, p = 0.198). The safety profile of the SSG + PM combination appears similar to that of SSG monotherapy. However, the combination offers advantages in terms of: - Shorter treatment duration (17 days vs 30 days for SSG alone) - Lower cost compared to SSG monotherapy In 2010, the World Health Organization (WHO) recommended this combination as a first-line treatment for visceral leishmaniasis in Eastern Africa.
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