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