Tags

Type your tag names separated by a space and hit enter

Treatment of New World cutaneous and mucosal leishmaniases.
Clin Dermatol. 1996 Sep-Oct; 14(5):519-22.CD

Abstract

The most extensive investigations of treatment of New World cutaneous leishmaniasis have been performed against L. panamensis disease in Colombia, and the relative value of regimens shown there may be instructive for disease from other areas. In Colombia, a 90-95% cure rate was achieved with three different drug regimens: The standard regimen of pentavalent antimony (20 mg/ kg/day for 20 days parenterally) A short course of pentamidine (3 mg/kg every other day for four injections intramuscularly The marketed combination of topical paromomycin (15%)-MBCl (12%) for 10 days, plus antimony (20 mg/kg/day parenterally) for 7 days. My view is that all these regimens could be chosen as first-line therapy for cutaneous disease in Colombia. The antimony regimen has the advantage of established use; the disadvantages are cost, requirement for injections each day for 20 days, and considerable morbidity in the last two weeks of therapy. The pentamidine regimen has the advantage of a short time course; the disadvantages are lack of experience with this new regimen and frequent, although moderate, morbidity. The combined topical-parenteral regimen has the advantage of requiring few and nontoxic injections; the primary disadvantage is that the regimen is novel and its efficacy has not been confirmed. It would be expected that cases of lesions in other areas caused by L. braziliensis complex would respond in a similar manner to these regimens. To date, however, only the efficacy of the standard antimonial regimen has been confirmed. In certain regions of Central America, other regimens may be effective. Thus, ketoconazole appears to be effective for the more rapidly self-curing forms of disease (cutaneous disease caused by L. mexicana and L. panamensis from Central America), and a short course of antimony may be effective against L. braziliensis in Guatemala.

Authors+Show Affiliations

Walter Reed Army Institute of Research, Washington, DC 20307-5100, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8889330

Citation

Berman, J D.. "Treatment of New World Cutaneous and Mucosal Leishmaniases." Clinics in Dermatology, vol. 14, no. 5, 1996, pp. 519-22.
Berman JD. Treatment of New World cutaneous and mucosal leishmaniases. Clin Dermatol. 1996;14(5):519-22.
Berman, J. D. (1996). Treatment of New World cutaneous and mucosal leishmaniases. Clinics in Dermatology, 14(5), 519-22.
Berman JD. Treatment of New World Cutaneous and Mucosal Leishmaniases. Clin Dermatol. 1996 Sep-Oct;14(5):519-22. PubMed PMID: 8889330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of New World cutaneous and mucosal leishmaniases. A1 - Berman,J D, PY - 1996/9/1/pubmed PY - 1996/9/1/medline PY - 1996/9/1/entrez SP - 519 EP - 22 JF - Clinics in dermatology JO - Clin Dermatol VL - 14 IS - 5 N2 - The most extensive investigations of treatment of New World cutaneous leishmaniasis have been performed against L. panamensis disease in Colombia, and the relative value of regimens shown there may be instructive for disease from other areas. In Colombia, a 90-95% cure rate was achieved with three different drug regimens: The standard regimen of pentavalent antimony (20 mg/ kg/day for 20 days parenterally) A short course of pentamidine (3 mg/kg every other day for four injections intramuscularly The marketed combination of topical paromomycin (15%)-MBCl (12%) for 10 days, plus antimony (20 mg/kg/day parenterally) for 7 days. My view is that all these regimens could be chosen as first-line therapy for cutaneous disease in Colombia. The antimony regimen has the advantage of established use; the disadvantages are cost, requirement for injections each day for 20 days, and considerable morbidity in the last two weeks of therapy. The pentamidine regimen has the advantage of a short time course; the disadvantages are lack of experience with this new regimen and frequent, although moderate, morbidity. The combined topical-parenteral regimen has the advantage of requiring few and nontoxic injections; the primary disadvantage is that the regimen is novel and its efficacy has not been confirmed. It would be expected that cases of lesions in other areas caused by L. braziliensis complex would respond in a similar manner to these regimens. To date, however, only the efficacy of the standard antimonial regimen has been confirmed. In certain regions of Central America, other regimens may be effective. Thus, ketoconazole appears to be effective for the more rapidly self-curing forms of disease (cutaneous disease caused by L. mexicana and L. panamensis from Central America), and a short course of antimony may be effective against L. braziliensis in Guatemala. SN - 0738-081X UR - https://www.unboundmedicine.com/medline/citation/8889330/Treatment_of_New_World_cutaneous_and_mucosal_leishmaniases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0738-081X(96)00048-X DB - PRIME DP - Unbound Medicine ER -