Leishmania aethiopica: Topical treatment with paromomycin and methylbenzethonium chloride ointment

Weinrauch, Louis; Katz, Marian; On, Jotaro

doi:10.1016/s0190-9622(87)80033-6

Cited by 9 publications

(9 citation statements)

References 10 publications

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“…A total of 808 study subjects participated in the 22 studies [ 8 – 11 , 13 – 18 , 25 – 36 ]. Twelve studies (nine case series [ 8 , 9 , 25 – 27 , 29 , 30 , 32 , 33 ] and three case reports [ 10 , 11 , 35 ]) documented treatment outcomes as part of routine clinical practice. All case series and case reports scored less than five in the NOS, but seven observational studies (five cohort studies [ 14 , 15 , 17 , 18 , 34 ] and two retrospective chart reviews [ 16 , 36 ]) scored five and above (Table A in S1 Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Studies report variation in treatment outcomes of CL due to L . aethiopica among immigrants [ 9 – 11 ]. A Belgian traveler who returned from northern Ethiopia had a complete resolution of the lesion with IM meglumine antimonate [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, an Eritrean immigrant in Germany showed healing with IV-amphotericin B [ 10 ]. As such, three Ethiopian immigrants in Israel had complete healing of lesion with a combination of 15% paromomycin sulfate and 12% methyl benzethonium chloride ointment [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Treatment outcomes of cutaneous leishmaniasis due to Leishmania aethiopica: A systematic review and meta-analysis

Alemu,

Derseh,

Kaba

et al. 2023

PLoS ONE

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Background Leishmania aethiopica is a unique species that causes cutaneous leishmaniasis (CL), and studies evaluating treatment outcomes for this condition reported inconsistent findings. This study aimed to summarize the evidence on treatment outcomes of CL caused by L. aethiopica to support decisions or propose further study. Methods We searched PubMed, Scopus, and ScienceDirect. In addition, we searched grey literature on Google Scholar and performed manual searching on the reference list of articles. Two authors did the screening, selection, critical appraisal, and data extraction. With the narrative synthesis of evidence, we performed a random effects model meta-analysis using the metaprop package in Stata 17. We did sensitivity and subgroup analyses after assessing heterogeneity using the I-squared test and forest plots. The funnel plot and Egger’s test were used to assess publication bias. Results The review included 22 studies with 808 participants, and the meta-analysis included seven studies with 677 participants. Most studies documented treatment outcomes with antimonial monotherapy, and only one study reported outcomes with combination therapy. The overall pooled proportion of cure was 63% (95% CI: 38–86%). In the subgroup analysis, systemic antimonial monotherapy showed a cure rate of 61%, and the proportion of cure was 87% with topical therapy. Topical therapy showed a better cure for the localized clinical phenotype. A cohort study documented a cure rate of 94.8% with combination therapy for the localized, mucocutaneous, and diffuse clinical phenotypes. The pooled proportion of unfavourable outcomes was partial response (19%), relapse (17%), discontinuation (19%), and unresponsiveness (6%). Conclusions The pooled proportion of cure is low with antimonial monotherapy. Despite limited evidence, combination therapies are a promising treatment option for all clinical phenotypes of CL caused by L. aethiopica. Future high-quality randomized control trials are needed to identify effective monotherapies and evaluate the effectiveness of combination therapies.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment outcomes of cutaneous leishmaniasis due to Leishmania aethiopica: A systematic review and meta-analysis

Alemu,

Derseh,

Kaba

et al. 2023

PLoS ONE

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“…In 1960s, it was reported to have antileishmanial effects in CL [7]. PA was initially investigated in different combinations with other drugs such as methyl benzalkonium chloride (MBCl), urea, and gentamicin (another aminoglycoside) [8][9][10][11][12].…”

Section: Topical Treatment Strategies In Clinical Trialsmentioning

confidence: 99%

Therapeutic advances in the topical treatment of cutaneous leishmaniasis: A review

et al. 2021

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Cutaneous leishmaniasis has been endemic since decades. Millions of cases are reported worldwide specially in developing and underdeveloped countries. There are 2 major types of cutaneous leishmaniasis based on the causating species found in different regions of the world. These include New and Old World cutaneous leishmaniasis, which are self-healing, but if not treated, these may cause severe scars and many other complications like mucosal involvement. The conventional gold standard treatment for both types is mainly intralesional or parenteral administration of antimonial. Lately, a great deal of research has been done on development of topical treatment based on single agent or combination therapy. This review summarizes the current state of literature regarding therapeutic outcome of topical treatment against cutaneous leishmaniasis caused by different species in different regions.

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“…At the early phase of trials of topical CL treatment using ointments/creams, some were found to be effective in healing the CL-lesions. Those were chlorpromazine ointment against diffuse-CL due to L. (L.) aethiopica, and paromomycin plus methylbenzethonium chloride against recurrent-or advanced-CL caused by L. (L.) major or L. (L.) aethiopica (El-On et al, 1985, 1986Weinrauch et al, 1987). Lipid formulations of amphotericin B could also be useful as a topical treatment for Old World CL in children (Zvulunov et al, 2003), and topical treatment with nanoliposomal amphotericin B reduces early lesion growth but fails to induce cure in an experimaental model of cutaneous leishmaniasis caused by L. (L.) mexicana (Varikuti et al, 2017).…”

Section: Ointment/cream Treatmentmentioning

confidence: 99%

Topical Treatment of Cutaneous Leishmaniasis: A Case Treated with A Glucantime-Based Lotion Experienced in Ecuador and A Mini Review

Kumar¹

2021

AMCR

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A 1.5-year-old male patient living in a remote community in the southeast of Manabí province of Ecuador was diagnosed as cutaneous leishmaniasis (CL) caused by Leishmania (Viannia) guyanensis. He was treated with a lotion, meglumine antimoniate Glucantime plus Merthiolate chloride, applying four to five times a day during eight weeks. The complete cure of lesion was obtained. This childhood-CL case did not respond against systemic therapy with Glucantime for the first cycle of regimen administered before the current topical treatment. Although systemic administration of pentavalent antimonials still remain as the first choice of treatment, it may often cause severe side effects, in addition to various disadvantages, such as painful injections, long-term regimens, difficulty to access health centers for patients living in remote/mountainous endemic areas. Therefore, as the alternatives, effective, easy-applicable and patient-compliant treatment is urgent need, especially for childhood-CL patients, who are highly vulnerable for toxic, systemic administrations of the drug. The current Glucantime plus Merthiolate lotion could be recommended as a future topical therapy of CLs, because of several advantages, easy-application, already-used drug as systemic therapy for the disease for a long time, more than 70 years.

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Leishmania aethiopica: Topical treatment with paromomycin and methylbenzethonium chloride ointment

Cited by 9 publications

References 10 publications

Treatment outcomes of cutaneous leishmaniasis due to Leishmania aethiopica: A systematic review and meta-analysis

Treatment outcomes of cutaneous leishmaniasis due to Leishmania aethiopica: A systematic review and meta-analysis

Therapeutic advances in the topical treatment of cutaneous leishmaniasis: A review

Topical Treatment of Cutaneous Leishmaniasis: A Case Treated with A Glucantime-Based Lotion Experienced in Ecuador and A Mini Review

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