The role of rifampicin in the management of cutaneous leishmaniasis

Kochar, Dhanpat Kumar; Aseri, Salmin; Sharma, Bhuwan; Bumb, R A; Mehta, Rajesh Dutt; Purohit, Shrirang

doi:10.1093/qjmed/93.11.733

Cited by 44 publications

(24 citation statements)

References 11 publications

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“…Oral rifampicin was administered to 50 patients, and the complete cure rate was 82%. Similar results were reported by the same center earlier by Kochar and others 18 and Bumb and Mehta, 19 with complete cure in 73.9% and 83.2% of cases, respectively, in all groups. Oral rifampicin was well-tolerated without any serious side effects.…”

Section: Discussionsupporting

confidence: 90%

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Pediatric Cutaneous Leishmaniasis in an Endemic Region in India

Agrawal¹,

Khandelwal²,

Bumb³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Cutaneous leishmaniasis (CL) is endemic in the Bikaner region situated in the Thar Desert of Rajasthan, India. This study describes clinicoepidemiological data of pediatric CL in pre-school children (0-5 years of age) from this region during 2001-2012. In total, 151 patients with 217 lesions were reported during the study period. The mean age of the study group was 3.29 ± 1.43 years (0.25-5 years), with many (41.7%) cases being in the age group of 2-4 years. Face was the most common site involved, and morphologically, the lesions were either plaque type or papulonodular. Smear for parasitologic examination was positive in 84 (70%) of 120 cases, and histopathologic examination confirmed CL in 10 (55.55%) of 18 cases. Parasite species identification conducted for 13 randomly selected patients by polymerase chain reaction identified Leishmania tropica as the causative species. Intralesional sodium stibogluconate was the most commonly used treatment and found to be well-tolerated. Other therapies that were effective included oral rifampicin, oral dapsone, radiofrequency heat therapy (RFHT), and combinations of the three therapies.

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Section: Discussionsupporting

confidence: 90%

“…It has the advantages of ease of administration, good safety profile, and minimal scarring posttreatment. 18,19 Salim and Kandil 20 reported complete resolution of lesions in 41 (89.1%) of 46 patients who underwent treatment with oral rifampicin. RFHT is a relatively newer modality for treatment of CL.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Cutaneous Leishmaniasis in an Endemic Region in India

Agrawal¹,

Khandelwal²,

Bumb³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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“…Five days of rifampin monotherapy at 1,200 mg was tolerated well by patients in the EBA study (30). Higher doses of rifampin did not cause tolerability problems in patients with brucellosis (900 mg, 45 days) or cutaneous leishmaniasis (1,200 mg, divided in two doses, 28 days) (79,143). The tolerability of rifampin in other diseases was reviewed in 650 patients; it was good with doses up to 1,200 mg but less favorable with doses of 1,800 mg (78).…”

Section: Old Drugs Revised: Higher Doses Of Rifamycinsmentioning

confidence: 90%

New Drugs against Tuberculosis: Problems, Progress, and Evaluation of Agents in Clinical Development

Boogaard

Kibiki

Kisanga

et al. 2009

Antimicrob Agents Chemother

216

132

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2One-third of the world population is infected with Mycobacterium tuberculosis (MTB) and hence at risk of developing active tuberculosis (TB). Each year, 8.8 million patients are newly diagnosed with active TB and 1.6 million patients die of TB. The rapid spread of the human immunodeficiency virus (HIV) has fueled the TB epidemic, especially in sub-Saharan Africa, where 28% of TB patients are HIV positive (176). The current first-line treatment for TB is a multidrug regimen consisting of rifampin, isoniazid, pyrazinamide, and ethambutol (RHZE). It must be taken for at least 6 months to achieve high cure rates (more than 95% in experimental settings). PROBLEMS WITH CURRENT TUBERCULOSIS TREATMENTThere are several major problems associated with the currently available TB treatment. First, the duration and complexity of treatment result in nonadherence to treatment. This leads to suboptimal response (failure and relapse), the emergence of resistance, and continuous spread of the disease (168). Second, adverse events in response to anti-TB drugs are common and contribute to the problem of nonadherence (19,168). Third, the increasing incidence of multidrug-resistant (MDR; resistance to at least rifampin and isoniazid) and extensively drug-resistant (XDR; MDR resistance plus resistance to a fluoroquinolone and an aminoglycoside) TB is a serious concern. Resistant TB occurs in the presence of partially suppressive drug concentrations that enable replication of bacteria, the formation of mutants, and overgrowth of wild-type strains by mutants (selective pressure) (175). The prevalence of MDR TB in new TB cases ranged from 0% in some Western European countries to more than 22% in Azerbaijan (2002 to 2007 survey); 14 of 72 participating countries reported an MDR TB prevalence of more than 5% (177). Second-line drugs for drug-resistant TB are not available everywhere and are less effective, more toxic, and require longer use than first-line drugs (61). Fourth, coinfection of TB and HIV is a problem by itself. Combined treatment of TB and HIV involves a high pill count with associated adherence problems, overlapping toxicity profiles of the antiretroviral and anti-TB drugs, drug interactions between rifampin and the antiretroviral protease inhibitors, and the risk of immune reconstitution syndrome (104). Fifth, prophylactic therapy of latent TB (TB infection without symptoms) with isoniazid is also associated with problems of nonadherence (180). Attempts to shorten treatment with alternative drugs resulted in severe adverse events (64,150,155).The World Health Organization (WHO) has developed the directly observed therapy short course (DOTS) strategy to optimize response and adherence to TB treatment. However, DOTS is labor-intensive and expensive. It causes a high burden on public health programs, especially in developing countries with limited human resources (49). In addition, TB diagnosis in the DOTS strategy is based on sputum microscopy, rather than sputum culture (173). Only advanced pulmonary TB is detected by sputum...

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“…7,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] Twenty-four RCTs are included in this group, two of which were also described in other groups. Predictably, this group was dramatically made up of heterogenic studies.…”

Section: Cryotherapy Alone or In Combination With Other Treatmentsmentioning

confidence: 99%