Successful treatment of New World cutaneous leishmaniasis with a combination of topical paromomycin/methylbenzethonium chloride and injectable meglumine antimonate

Clin Infect Dis. 1995 Jan;20(1):47-51. doi: 10.1093/clinids/20.1.47.

Abstract

Colombian patients with New World cutaneous leishmaniasis were treated with a combination of a topical formulation (15% paromomycin sulfate/5% methylbenzethonium chloride, twice a day) and parenteral meglumine antimonate (20 mg of antimony [Sb]/kg.d]). Cohort 1 received topical therapy for 10 days and Sb for 7 days; 18 (90%) of the 20 patients were cured (follow-up, 12 months). Other clinical data suggested that neither the topical formulation alone nor the 7-day regimen of Sb alone would have cured many patients. In a subsequent cohort, which received topical therapy for 10 days and Sb for 3 days, the cure rate was 42% (eight of 19 patients). In Colombian cohorts (historical controls) treated with Sb alone for 10-15 days, the cure rate was 31%-36%. Side effects in cohort 1 patients consisted of local reactions to the topical formulation: burning and pruritus in 25% of patients and vesicle formation in 15% of patients. This is the first report that a regimen partially composed of topical antimicrobial agents can be highly effective for treatment of New World cutaneous leishmaniasis.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase II
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Adolescent
  • Adult
  • Animals
  • Antiprotozoal Agents / administration & dosage
  • Antiprotozoal Agents / adverse effects
  • Benzethonium / administration & dosage
  • Benzethonium / adverse effects
  • Benzethonium / analogs & derivatives*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Humans
  • Injections, Intramuscular
  • Injections, Intravenous
  • Leishmania braziliensis
  • Leishmaniasis, Cutaneous / drug therapy*
  • Leishmaniasis, Cutaneous / parasitology
  • Leishmaniasis, Mucocutaneous / drug therapy
  • Leishmaniasis, Mucocutaneous / parasitology
  • Male
  • Meglumine / administration & dosage*
  • Meglumine / adverse effects
  • Meglumine Antimoniate
  • Middle Aged
  • Organometallic Compounds / administration & dosage*
  • Organometallic Compounds / adverse effects
  • Paromomycin / administration & dosage*
  • Paromomycin / adverse effects

Substances

  • Antiprotozoal Agents
  • Organometallic Compounds
  • Benzethonium
  • Paromomycin
  • Meglumine
  • Meglumine Antimoniate
  • methylbenzethonium chloride