Sodium Stibogluconate Treatment for Cutaneous Leishmaniasis : A Clinical Study of 43 Cases from the North of Jordan

Abstract

Objective: to study the efficacy of Sodium Stibogluconate intramuscular injections in the treatment of cutaneous leishmaniasis, safety and side effects. Method: A total 43 patients were seen over a period of 12 months, from January 2009 to December 2010. All cases were seen at Prince Rashed Military Hospital in the north of Jordan. The diagnosis of localized cutaneous leishmania was made on clinical grounds proved by leishmania smear or skin biopsy. The distribution of patients according to gender, age groups, time of the year, was made. The criteria for sodium stibogluconate injection were: the severity of symptoms, site of lesion on face (ear, nose and cheek), and multiplicity of lesions. The dose of sodium stibogluconate given was 10 mg\kg given as intramuscular injections daily for total two weeks followed by complete blood count, liver function test, electrocardiogram as base line. Results: 23 patients were males and 20 were females (16 of them were 14 years and below). The age group ranged from 2-72 years. One patient (2.3%) had resistant infection to sodium stibogluconate; and an admission was for one patient (2, 3%) for a few days because of a picture of Hepatotoxicity. 42 patients showed improvement of the lesion (98%); improvement is defined when the lesion flattens and ulceration disappears. One patient (2.3%) demonstrated increase in liver enzymes after one week of treatment’ upon stopping treatment for one week the patient then resumes treatment with no complications and with complete remission. Conclusion: Many cases of cutaneous leishmaniasis are seen in Jordan causing cosmetic problems. Early introduction of systemic anti-leishmania agent is recommended. Sodium stibogluconate is an effective way to decrease scarring and dispigmentation, with minimum side effects.