Azithromycin in the treatment of mucosal leishmaniasis

Silva‐Vergara, Mario León; Silva, Luciana de Almeida; Maneira, Frederico Ricardo Zago; Silva, Achilles Gustavo da; Prata, Áluízio

doi:10.1590/s0036-46652004000300011

Cited by 27 publications

(20 citation statements)

References 16 publications

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“…However, its use is limited to patients with treatment failure or contraindications for all other options, such as young children, pregnant women, or patients with a severe underlying disease [157,158].…”

Section: Azithromycinmentioning

confidence: 99%

Leishmaniasis in travelers: A literature review

Mansueto

Seidita

Vitale

et al. 2014

Travel Medicine and Infectious Disease

108

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Summary Leishmaniasis is a vector-borne protozoan infection whose clinical spectrum ranges from asymptomatic infection to fatal visceral leishmaniasis. Over the last decades, an increase in imported leishmaniasis cases in developed, non-endemic countries, have been pointed-out from a review of the international literature. Among the possible causes are increasing international tourism, influx of immigrants from endemic regions and military operations. The main area for the acquisition of cutaneous leishmaniasis, especially for adventure travelers on long-term trips in highly-endemic forested areas, is represented from South America, whereas popular Mediterranean destinations are emerging as the main areas to acquire visceral variant. Leishmaniasis should be considered in the diagnostic assessment of patients presenting with a compatible clinical syndrome and a history of travel to an endemic area, even if this occurred several months or years before. Adventure travelers, researchers, military personnel, and other groups of travelers likely to be exposed to sand flies in endemic areas, should receive counseling regarding leishmaniasis and appropriate protective measures. ª

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Section: Azithromycinmentioning

confidence: 99%

Leishmaniasis in travelers: A literature review

Mansueto

Seidita

Vitale

et al. 2014

Travel Medicine and Infectious Disease

108

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“…In an open trial in Brazil, it cured 16 out of 20 patients with cutaneous ulcers caused by Leishmania (Viannia) braziliensis, however, cure time, doses and cycles number presented high variability (PRATA et al, 2003). In the same location; three out of four old individuals with mucosal involvement presented clinical cure after several cycles with this drug (SILVA-VERGARA et al, 2004). Most recently, in an open study, none of 45 Syrian old-world leishmaniasis patients treated with azithromycin were cured (DAOUD & BOUSHI, 2006).…”

Section: Introductionmentioning

confidence: 99%

Failure of both azithromycin and antimony to treat cutaneous leishmaniasis in Manaus, AM, Brazil

Teixeira

Paes

Guerra

et al. 2008

Rev. Inst. Med. trop. S. Paulo

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SUMMARYA non-randomized controlled clinical trial was carried out in order to evaluate both azithromycin and antimony efficacy in cutaneous leishmaniasis in Manaus, AM, Brazil. Forty nine patients from both genders, aged 14 to 70, with cutaneous ulcers for less than three months and a positive imprint for Leishmania spp. amastigotes were recruited into two groups. Group I (26 patients) received a daily-single oral dose of 500 mg of azithromycin for 20 days and Group II (23 patients) received a daily-single intramuscular dose of 20 mg/kg of meglumine antimony, also for 20 days. Azithromycin cured three of 24 (12.5%) patients on days 60, 90 and 120 respectively whereas therapeutic failure was considered in 21 of 24 (87.5%) cases. In group II, antimony cured eight of 19 (42.1%) cases as follows: three on day 30, one each on day 60 and day 90, and three on day 120. Therapeutic failure occurred in 11 of 19 (57.9%) individuals. The efficacy of antimony for leishmaniasis was better than azithromycin but analysis for the intention-to-treat response rate did not show statistical difference between them. Although azithromycin was better tolerated, it showed a very low efficacy to treat cutaneous leishmaniasis in Manaus.

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“…Contrasting with these findings, in an area endemic for Leishmania (Leishmania) major in Syria, no cures were recorded among 45 patients with cutaneous leishmaniasis using ten-day cycles of azithromycin 1 . Three cases of mucosal leishmaniasis with contraindications for the use of antimonials were successfully treated with three cycles of ten days of azithromycin in Brazil 12 .…”

Section: Resultsmentioning

confidence: 99%

The activity of azithromycin against Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis in the golden hamster model

Sinagra

Luna

Abraham

et al. 2007

Rev. Soc. Bras. Med. Trop.

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New therapeutic alternatives against leishmaniasis remain a priority. The activity of azithromycin against Leishmania (Leishmania) major has been previously demonstrated. Different responses among species of Leishmania make species-specific drug screening necessary. The activity of azithromycin against Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis was evaluated in golden hamsters infected through footpad injections of metacyclic promastigotes, and compared with untreated controls and animals treated with meglumine antimoniate. Footpad thickness, lesion cultures and dissemination sites were analyzed. Treatment of golden hamsters with oral azithromycin at 450mg/kg had no activity against infections with Leishmania (Leishmania) amazonensis. For infections due to Leishmania (Viannia) braziliensis, azithromycin demonstrated significant activity relative to untreated controls, but inferior to meglumine antimoniate, for controlling lesion size. Neither drug was able to totally eliminate parasites from the lesions. It was concluded that azithromycin has activity against Leishmania (Viannia) braziliensis but not against Leishmania (Leishmania) amazonensis in this model.

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Azithromycin in the treatment of mucosal leishmaniasis

Cited by 27 publications

References 16 publications

Leishmaniasis in travelers: A literature review

Leishmaniasis in travelers: A literature review

Failure of both azithromycin and antimony to treat cutaneous leishmaniasis in Manaus, AM, Brazil

The activity of azithromycin against Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis in the golden hamster model

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