ABSTRACT
Twenty-seven patients were randomly picked for an open pilot study using terbinafine with a dose range of 250-500 mg/day for 4 weeks. The inclusion criteria were as follows: (1) the patient had to be aged 5 years or older; (2) the patient could be of either sex; (3) any number or location of the lesions was allowed; (4) parasitologic confirmation was required; (5) the patient was allowed no previous treatment; (6) pregnant or lactating patients were excluded; (7) informed consent from the patient or his/her parents was required. The parasitologic diagnosis was carried out by a slit smear technique followed by a Giemsa stain for parasite identification. Terbinafine was given in two different doses to two groups sorted according to age. The groups were as follows: Group 1, 5-15 years, 125 mg orally twice daily for 4 weeks: Group 2, > 15 years, 250 mg orally twice daily for 4 weeks. Laboratory blood investigations including complete blood count, creatinine, urea, and liver function tests were carried out initially and at 2 weeks and 4 weeks. Clinical response was evaluated by assessing the per cent of improvement of erythema, induration, and ulceration at 2 weeks and at 4 weeks after admission. The final assessment was reported at 4 weeks: complete cure, 100% improvement with no relapse; partial cure, > or = 60% improvement; failure, < 60% improvement. Overall clinical response included patients with both complete and partial cure. Follow-up for patients with complete cure was carried out monthly for 6 months to assess the relapse rate. Patients with partial cure or failure were switched to sodium stibogluconate intralesionally.
Subject(s)
Leishmania tropica , Leishmaniasis, Cutaneous/drug therapy , Naphthalenes/administration & dosage , Trypanocidal Agents/administration & dosage , Administration, Oral , Adolescent , Animals , Child , Child, Preschool , Female , Humans , Leishmaniasis, Cutaneous/parasitology , Male , Naphthalenes/therapeutic use , Pilot Projects , Terbinafine , Treatment Outcome , Trypanocidal Agents/therapeutic useABSTRACT
BACKGROUND: Various therapeutic modalities have been used for treating cutaneous leishmaniasis. Intralesional pentavalent antimonial injection is one of the effective therapeutic modalities. In this study, the efficacy of three different intralesional schedules with sodium stibogluconate have been investigated. METHODS: Ninety-six patients with 129 lesions were entered into the study, all with confirmed diagnosis of cutaneous leishmaniasis. The lesions were treated with three different schedules, including daily, alternate day, and weekly interlesional injections of sodium stibogluconate. The clinical response was then compared to arrive at the most effective schedule. RESULTS: The clinical responses (complete and partial cure) were 67%, 97%, and 91% for the daily, alternate-day, and weekly schedules, respectively. Lesions with either partial cure or failure of treatment were injected weekly with the same medication until complete cure had been achieved. The final overall success rate of complete cure was 99.2%. CONCLUSIONS: Alternate day or weekly intralesional treatment of cutaneous leishmaniasis with sodium stibogluconate are more effective than daily treatments.