An intermittent schedule is better than continuous regimen of antimonial therapy for cutaneous leishmaniasis in the municipality of Rio de Janeiro, Brazil

Abstract

This study reviews a series of cutaneous leishmaniasis cases diagnosed and treated in outpatient units in the municipality of Rio de Janeiro, where the intermittent schedule of antimonial therapy was replaced by the continuous regimen. Both schedules were based on daily intramuscular injections of pentavalent antimonial. Forty-nine subjects received the intermittent regimen, consisting of three ten-day series alternated with ten-day rest intervals whereas seventy-one patients received the continuous regimen during 20 consecutive days. The study groups had similar composition regarding age, sex and clinical condition. The cure rate was significantly higher in the group receiving the intermittent schedule than in the group receiving continuous therapy (89.8% vs 63.3%). Moreover, loss to follow-up was significantly more frequent in the group receiving continuous therapy (19.7% vs 4.1% in the intermittent therapy). Under field conditions, the intermittent regimen provided higher effectiveness and adherence than the continuous schedule.

Clinical, laboratory, and therapeutic characteristics of American tegumentary leishmaniasis in the 15 th State Health Division, Northwest Paraná State, Southern Brazil

“…Failure of treatment with PA occurred in 6.4% of patients. This failure rate was lower than that described by the World Health Organization (WHO) (26) and that reported in Rio de Janeiro State (12.5%) (32) . In these cases, amphotericin B (2.3%) and pentamidine (0.9%) were used instead.…”

“…In the present study, 95.0% of patients with the cutaneous form and 85.7% of those with the mucosal form were considered to be cured, which were higher than those (59.1%) described in Northern Paraná State (17) , in Alagoas State (44.5%) (19) , and in Rio de Janeiro State (74%) (32) . Similar results were reported by Name et al (28) who found a clinical cure rate of 81.6% in patients with the cutaneous form and 69.6% in patients with the mucocutaneous form in Brasília.…”

Estudo clínico, epidemiológico e terapêutico de 402 pacientes com leishmaniose tegumentar americana atendidos no Hospital Universitário de Brasília, DF, Brasil

“…7 CF cure rates attained with the use of pentavalent antimony were compatible to those found by other authors. 14,22,23 In the case of MCF, these rates were smaller, thus reaffirming the greater difficulty found in the treatment of this form of the disease (Table 1). Results indicating otherwise might be derived, for instance, from methodologies different than the one employed in this study.…”

Risk factors associated with dizziness during treatment of mucosal leishmaniasis with meglumine antimoniate: 16-year retrospective study of cases from Rio de Janeiro, Brazil

“…1,4 The two main therapeutic agents, meglumine antimoniate and sodium stibogluconate, differ in terms of dosage, treatment duration and administration frequency (continuous or intermittent). [5][6][7][8][9] At the Laboratory of Leishmaniasis Surveillance, Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, we have found continuous or intermittent intramuscular administration of meglumine antimoniate at a dose of 5 mg/kg/day to be effective and well tolerated. [10][11][12][13][14][15] The main side effects of treatment with pentavalent antimonials are myalgia, arthralgia, electrocardiographic Q-T interval prolongation, renal failure and pancreatitis accompanied by elevated lipase levels, among others.…”