A Low-Dose Antimony Treatment in 159 Patients with American Cutaneous Leishmaniasis: Extensive Follow-up Studies (Up to 10 Years)

Oliveira-Neto, Manoel P.; Schubach, Armando; Mattos, Marise; Gonçalves-Costa, S. C.; Pirmez, Claude

doi:10.4269/ajtmh.1997.57.651

Cited by 95 publications

(84 citation statements)

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“…In contrast, in Manaus only 42.5% of the patients were cured with this drug similar to other results already published (OLIVEIRA- NETO et al, 1997;ROMERO et al, 2001). These data support the high variability in cure rate of this disease depending on Leishmania spp., the clinical picture and the geographical region (SARAVIA et al, 1989;ROMERO et al, 2001;SOTO & TOLEDO, 2007).…”

Section: Resultssupporting

confidence: 89%

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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Section: Resultssupporting

confidence: 89%

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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“…In the New World, the efficacy of anti monials for the treatment of cutaneous leishmaniasis has been variable. In Bolivia, treatment failure was observed in 7% of patients [78], in 16% in Brazil [79], and in 39% of patients in Colombia [80]. In the Old World, failure of this drug is approximately 13%, and this drug is considered as satisfactory for the treatment of cutaneous leishmaniasis.…”

Section: First-line Drugsmentioning

confidence: 99%

Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

Goto¹,

Lindoso

2010

Expert Review of Anti-infective Therapy

382

388

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“…A 25% difference was considered clinically significant, taking into account the potential benefits of a 10-day treatment as opposed to 20 days, the high efficacy of pentavalent antimonials reported in the literature for the treatment of New World cutaneous leishmaniasis (88-100%) 5,8,[13][14][15][16] and the 100% cure we obtained in a previous pilot study involving 10 adult patients treated with meglumine antimonate for 10 days (Ochoa MT, unpublished data). The number of participants in the total study population was increased to 136 to compensate for the expected loss to follow-up.…”

Section: Patientsmentioning

confidence: 99%

“…4 Reduction in the daily dose with a longer period of administration has been evaluated with success in Brazil. 5 However, a reduction in the duration of treatment, rather than in the daily dose, could decrease adverse effects, as well as the number of contacts with medical personnel, thereby improving adherence and lowering costs. In this regard, Arana and others reported 90% efficacy using ten days of antimonial therapy in Guatemala for lesions caused by Leishmania (Viannia) braziliensis in young male soldiers.…”

Section: Introductionmentioning

confidence: 99%

Treatment failure in children in a randomized clinical trial with 10 and 20 days of meglumine antimonate for cutaneous leishmaniasis due to Leishmania viannia species.

Palácios¹,

Osório²,

Grajalew³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

116

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Abstract. Clinical response to supervised treatment of Colombian patients with cutaneous leishmaniasis was evaluated in a randomized controlled trial comparing 10 days versus 20 days of treatment with meglumine antimonate (20 mg Sb/kg/day). Masked examiners evaluated clinical response defined as 100% re-epithelialization of all lesions at 13 weeks and no relapses during 52 weeks of follow-up. The efficacy of meglumine antimonate for 10 days' treatment was 61% (28 of 46) compared to 67% (24 of 36) for 20 days. There was a significantly lower clinical response for children Ͻ 5 years in both 10-day (11%) and 20-day (25%) groups compared to patients aged 5-14 years (67% and 75%, respectively) and 15 years or more (81% and 83%, respectively). Overall efficacy of treatment schedules was comparable, but lower than expected, mainly because of low efficacy in children. Pathogenicity of infection and pharmacokinetics may affect the treatment response in children. New therapeutic alternatives should be evaluated in trials that include children and women.

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A Low-Dose Antimony Treatment in 159 Patients with American Cutaneous Leishmaniasis: Extensive Follow-up Studies (Up to 10 Years)

Cited by 95 publications

References 0 publications

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

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

Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis

Treatment failure in children in a randomized clinical trial with 10 and 20 days of meglumine antimonate for cutaneous leishmaniasis due to Leishmania viannia species.

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