Is Itraconazole Plus Clofazimine an Effective Treatment for Cutaneous Leishmaniasis?

Abstract

Background: Leishmaniasis is endemic in 88 countries and has a worldwide prevalence of 12 million. Cutaneous leishmaniasis (CL) cases deserve the highest attention due to their magnitude and risk of causing scars in humans. Although several studies have been performed on novel therapies, treatment failure and drug resistance are still common, and most systemic treatments are parenteral. Thus, in this study, it was attempted to find an effective combination oral therapy for this disease. Case Series: Six patients (between 35 and 64 years old) with confirmed CL were treated with a combination of clofazimine (CLZ, 200 mg/d) and itraconazole (ITN, 300 mg/d) for 4 weeks. Then, ITZ 300 mg/d was given for another 4 weeks. All patients were followed up to assess the efficacy and side effects of this treatment regimen. Every single lesion in the patients was remarkably smaller after the course of the treatment (P=0.001), and skin smears became negative. Conclusion: The combination of CLZ and ITN could be a helpful treatment modality in the treatment of CL. However, more and larger studies should be conducted to assess the efficacy and side effects of this combination therapy.