Towards a standard protocol for antimony intralesional infiltration technique for cutaneous leishmaniasis treatment
Mem. Inst. Oswaldo Cruz
; 113(2): 71-79, Feb. 2018. tab, graf
Article
in English
| LILACS
| ID: biblio-894896
Responsible library:
BR1.1
ABSTRACT
BACKGROUND Despite its recognised toxicity, antimonial therapy continues to be the first-line drug for cutaneous leishmaniasis (CL) treatment. Intralesional administration of meglumine antimoniate (MA) represents an alternative that could reduce the systemic absorption of the drug and its side effects. OBJECTIVES This study aims to validate the standard operational procedure (SOP) for the intralesional infiltration of MA for CL therapy as the first step before the assessment of efficacy and safety related to the procedure. METHODS The SOP was created based on 21 trials retrieved from the literature, direct monitoring of the procedure and consultation with experts. This script was submitted to a formal computer-aided inspection to identify readability, clarity, omission, redundancy and unnecessary information (content validation). For criterion and construct validations, the influence of critical condition changes (compliance with the instructions and professional experience) on outcome conformity (saturation status achievement), tolerability (pain referred) and safety (bleeding) were assessed. FINDINGS The median procedure length was 12 minutes and in 72% of them, patients classified the pain as mild. The bleeding was also classified as mild in 96.6% of the procedures. Full compliance with the SOP was observed in 66% of infiltrations. Despite this, in 100% of the inspected procedures, lesion saturation was observed at the end of infiltration, which means that it tolerates some degree of modification in its execution (robustness) without prejudice to the result. CONCLUSIONS The procedure is reproducible and can be used by professionals without previous training with high success and safety rates.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Health and Well-Being
Health problem:
Target 3.3: End transmission of communicable diseases
Database:
LILACS
Main subject:
Injections, Intralesional
/
Leishmaniasis, Cutaneous
/
Meglumine
/
Antiprotozoal Agents
Type of study:
Practice guideline
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Mem. Inst. Oswaldo Cruz
Journal subject:
Tropical Medicine
/
Parasitology
Year:
2018
Document type:
Article
/
Project document
Affiliation country:
Brazil
Institution/Affiliation country:
Fundação Oswaldo Cruz-Fiocruz/BR