Topical treatment of Old World cutaneous leishmaniasis caused by Leishmania major: A double-blind control study

El‐On, Joseph; Halevy, Sima; Grunwald, Marcelo H.; Weinrauch, Louis

doi:10.1016/0190-9622(92)70175-f

Cited by 152 publications

(76 citation statements)

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“…8 The topical application of PR (15%) plus methylbenzethonium chloride (MBCL; 12%) in a soft paraffin-based ointment was effective against Leishmania major in both experimental animals and in humans. [9][10][11] In a study of 52 patients with CL in Ecuador, it was reported that after 20 applications of PR ointment over 10 or 20 days, 90% of lesion were cured at 100 days after treatment and 85% at the 1-year follow-up examination, but only 9% of the lesions of untreated patients healed spontaneously after 50 days. 12 However, this controlled trial under field conditions did not include randomization or placebo treatment.…”

Section: Introductionmentioning

confidence: 99%

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

Arana¹,

Mendoza²,

Rizzo³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

114

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Abstract. A double-blind, randomized trial was undertaken in Guatemala to determine the therapeutic efficacy of an ointment for the treatment of cutaneous leishmaniasis that contained 15% paromomycin and 12% methylbenzethonium chloride and that was applied twice a day for 20 days. The treatment group included 35 patients, and the placebo group included 33 patients. The initial clinical response rate (13 weeks after completing the treatment) was 91.4% in the treatment group and 39.4% in the placebo group. The final clinical response rate at the 12-month followup examination was 85.7% (31 of 35) in the treatment group and 39.4% (13 of 33) in the placebo group (P Յ 0.001). In general, the treatment was well tolerated and was never interrupted because of adverse effects. The number of adverse effects reported in the placebo group was lower than in the treatment group (16 events versus 30 events). All adverse effects reported by patients disappeared within 1 week of completing the treatment. Our findings show that the combination of paromomycin with methylbenzethonium chloride for 20 days is a good alternative for antimonial treatments of cutaneous leishmaniasis in Guatemala.

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Section: Introductionmentioning

confidence: 99%

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

Arana¹,

Mendoza²,

Rizzo³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

114

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“…In einer nicht randomisierten, doppelblind durchgeführten, kontrollierten Studie in Israel war die topische Behandlung mit 15% Paromomycinsulfat 2-mal täglich über 10 Tage sehr wirksam gegen L.-major-Infektionen.In anderen Ländern konnte dies jedoch nicht bestätigt werden [10,18]. Lokale Kryotherapie sowie Hitzeanwendung wurden ebenfalls erprobt [4,26].…”

Section: > Die Therapie Beträgt Bei Kutaner Leishmaniose 20 Und Bei Dunclassified

Kutane Leishmaniose

Enk

Gardlo

Hochberg³

et al. 2003

Hautarzt

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Leishmaniasis is a vector-borne disease caused by an obligate intracellular protozoa, Leishmania, which resides in macrophages. The parasite is transmitted by an infected female sandfly. The incidence of cutaneous leishmaniasis approaches 2 million new cases per year with 90% of the cases occurring in the "Old World", while the "New World" accounts for the rest. Infection may be restricted to the skin with development of characteristic ulcers, or may affect the mucous membranes in its mucocutaneous form. The clinical diagnosis is verified by the presence of amastigotes in slit-skin smears. Therapeutic modalities include systemic treatments such as the pentavalent antimony compound sodium stibogluconate, liposomal formulations of amphotericin B, oral ketoconazole or itraconazole, as well as topical paromomycin sulphate, local heat, freezing with liquid nitrogen, or photodynamic therapy. An effective vaccine is not available.

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“…Ointment containing 15 percent paromomycin is believed to be the treatment of choice for Old World cutaneous leishmaniasis in Israel (where L. major is also the most common pathogen) with cure rate of 76 to 86 percent after a single two-week course of daily topical application (El-On et al, 1992;Zvulunov et al, 2003). Topical application of the liposomal form of paromomycin, experimentally evaluated in vivo, is believed to provide a promising effective topical treatment for CL (Carneiro et al, 2010).…”

Section: Paromomycinmentioning

confidence: 99%

Topical Treatment Modalities for Old World Cutaneous Leishmaniasis: A Review

2012

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Diagnosis and therapy of cutaneous leishmaniasis (CL) can be difficult due to the variability of the clinical pictures and resistance to therapy. There is no vaccine currently available for CL. The aim of the present review is to describe different topical treatment modalities for old world CL. The mainstays of treatment for old world CL are pentavalent antimony compounds which are administered parenterally or intralesionally. New topical treatment alternatives have been available within the past few years. Amongst several treatments used topically, physical therapies including cryotherapy, heat therapy and CO 2 laser are promising for the treatment of old world CL. Along with that, other randomized placebo controlled trials should be designed to find new effective therapeutic regimens.

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Topical treatment of Old World cutaneous leishmaniasis caused by Leishmania major: A double-blind control study

Cited by 152 publications

References 4 publications

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

Kutane Leishmaniose

Topical Treatment Modalities for Old World Cutaneous Leishmaniasis: A Review

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