High-Dose Oral Fluconazole Therapy Effective for Cutaneous Leishmaniasis Due to Leishmania (Vianna) braziliensis

Sousa, Anastácio Q.; Frutuoso, Mércia S.; Moraes, E.; Pearson, Richard D.; Pompeu, Margarida M. L.

doi:10.1093/cid/cir496

Cited by 73 publications

(55 citation statements)

References 9 publications

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“…14,15 High doses of fluconazole are required for L. braziliensis infections. 16 The miltefosine cure rate varies from 82% in Guatemala to 33% in Colombia. 17 The cure rate is dose dependent and can reach 94% 18 for New World strains.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Sensitivity of Cutaneous Leishmania Promastigote Isolates Circulating in French Guiana to a Set of Drugs

Ginouvès¹,

Simon²,

Demar³

et al. 2017

Am J Trop Med Hyg

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Abstract. Anti-leishmaniasis drug resistance is a common problem worldwide. The aim of this study was to inventory the general in vitro level of sensitivity of Leishmania isolates circulating in French Guiana and to highlight potential in vitro pentamidine-resistant isolates. This sensitivity study was conducted on 36 patient-promastigote isolates for seven drugs (amphotericin B, azithromycin, fluconazole, meglumine antimoniate, miltefosine, paromomycin, and pentamidine) using the Cell Counting Kit-8 viability test. The IC 50 values obtained were heterogeneous. One isolate exhibited high IC 50 values for almost all drugs tested. Pentamidine, which is the first-line treatment in French Guiana, showed efficacy at very low doses (mean of 0.0038 μg/mL). The concordance of the in vitro pentamidine results with the patients' clinical outcomes was 94% (K = 0.82).

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Section: Introductionmentioning

confidence: 99%

In Vitro Sensitivity of Cutaneous Leishmania Promastigote Isolates Circulating in French Guiana to a Set of Drugs

Ginouvès¹,

Simon²,

Demar³

et al. 2017

Am J Trop Med Hyg

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“…One prospective observational study evaluated cure rates for cutaneous L. (V.) braziliensis with escalating doses of fluconazole, administered for 4-12 weeks [63]. Fluconazole cured all patients (n=8) treated with 8 mg/kg/day, compared with 93 % (n=14) dosed at 6.5 mg/kg/day and 75 % (n=8) at 5 mg/kg/day [63].…”

Section: Oral Azoles (Fluconazole Ketoconazole)mentioning

confidence: 99%

Cutaneous Leishmaniasis in Travellers: a Focus on Epidemiology and Treatment in 2015

Showler

Boggild

2015

Curr Infect Dis Rep

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Imported cutaneous leishmaniasis (CL) is a growing problem with increasing global travel to endemic areas. Returned travellers seeking care encounter significant barriers to treatment, including diagnostic delays and difficult access to anti-leishmanial drugs. Treatment recommendations in non-endemic settings are a moving target, reflecting recent developments in Leishmania diagnostics and therapeutics. Accumulating experience with molecular-based species identification has enabled species-directed therapy. Clinicians are reevaluating more toxic traditional regimens in light of newly approved therapeutic agents and emerging data on local cutaneous treatments. Referral centers are implementing treatment decision algorithms designed to maximize efficacy while minimizing adverse events. Although management strategies continue to evolve, treatment of CL in non-endemic settings remains controversial. Persistent reliance on expert opinion reflects lack of research focused on travellers and limited randomized controlled trial evidence. We herein review the current epidemiology of cutaneous leishmaniasis in travellers and species-specific evidence for available therapies.

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“…Other treatment options include pentamidine and amphotericin B, which are both injectable and have a safety profi le that is similar to antimony and the lipid formulations of amphotericin B, wich are expensive optionsfor the majority of the CL endemic countries. Various studies evaluated oral drugs as candidates for CL treatment, such as miltefosine [5][6][7] , fl uconazole 8,9 , and azithromycin [10][11][12][13][14][15] , with controversial results or no clear evidence of efficacy.…”

mentioning

confidence: 99%

Poor response to azithromycin in cutaneous leishmaniasis leading to a premature interruption of a multicentric phase III clinical trial in Brazil

Toledo

Daher

Amaral

et al. 2014

Rev. Soc. Bras. Med. Trop.

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High-Dose Oral Fluconazole Therapy Effective for Cutaneous Leishmaniasis Due to Leishmania (Vianna) braziliensis

Cited by 73 publications

References 9 publications

In Vitro Sensitivity of Cutaneous Leishmania Promastigote Isolates Circulating in French Guiana to a Set of Drugs

In Vitro Sensitivity of Cutaneous Leishmania Promastigote Isolates Circulating in French Guiana to a Set of Drugs

Cutaneous Leishmaniasis in Travellers: a Focus on Epidemiology and Treatment in 2015

Poor response to azithromycin in cutaneous leishmaniasis leading to a premature interruption of a multicentric phase III clinical trial in Brazil

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