Treatment Of New World Cutaneous Leishmaniasis Research Articles

Miltefosine for Old World cutaneous leishmaniasis: An experimental study on Leishmania major infected mice

BackgroundLeishmaniasis is one of the neglected diseases included in the World Health Organization's list of the top guns of antimicrobial resistance. Miltefosine (MIL) was the first successful oral agent used against visceral leishmaniasis in India. As regards cutaneous leishmaniasis (CL), multiple experimental and clinical studies have investigated its efficacy in treatment of New World CL, while only few trials have focused on Old World CL. Therefore, this work was designed to study the efficacy of MIL in experimental Old World CL caused by Leishmania major (MHOM/IL/81/FEBNI), one of the causative species of CL in the Middle East. ResultsGroups of infected mice were given MIL orally, at a dose of 20mg/kg/day for 20days. Results showed that untreated infected mice suffered from autoamputation of the inoculated footpads. While, those treated with MIL showed complete clinical cure, significant reduction of parasite burden and improvement of the histopathological changes of the cutaneous lesions. The drug causes evident ultrastructural morphological alterations of L. major amastigote form. One month post-treatment, no clinical sings of relapse were observed, and parasite density continued to decrease significantly. ConclusionThe present study revealed activity of MIL against experimental Old World CL in the mouse model caused by L. major (MHOM/IL/81/FEBNI), one of the causative species of CL in the Middle East.

Successful liposomal amphotericin B treatment of Leishmania braziliensis cutaneous leishmaniasis

Existing systemic treatments for New World cutaneous leishmaniasis (CL) caused by Leishmania (vianna) braziliensis are unsatisfactory. Liposomal amphotericin B has been used extensively for the treatment of visceral leishmaniasis, but in few cases of CL, and an appropriate regimen for CL has not been described. We successfully treated a patient with multiple L. braziliensis CL lesions acquired in Belize. Liposomal amphotericin B (AmBisome) was given to our patient as an inpatient for seven daily doses of 3 mg kg(-1) day(-1) and then as an outpatient at 3 mg kg(-1) twice weekly for a further three weeks, a total of 40 mg kg(-1). Liposomal amphotericin offers a well-tolerated alternative to pentavalent antimony or amphotericin B deoxycholate for the systemic treatment of New World CL.

Topical treatment of New World cutaneous leishmaniasis in Belize: A clinical study

Many studies have been performed during the past decade to find an effective topical therapy for cutaneous leishmaniasis (CL). Our purpose was to evaluate the effect of paromomycin ointment (P-ointment) containing 15% paromomycin sulfate and 12% methylbenzethonium chloride on Belizean patients with New World CL. Fifty-three patients were treated twice daily for 14 to 21 days with P-ointment. Sixty-eight percent of the patients healed, 6% had a delayed cure, and 26% did not respond. No toxic effects from the ointment were observed. Topical paromomycin is as efficacious in the treatment of New World CL as other currently accepted modalities that are potentially more toxic.