Treatment of cutaneous leishmaniasis with 20% paromomycin ointment

Abstract

Cutaneous leishmaniasis is an infectious disease caused by flagellate protozoa of the genus Leishmania. In Mediterranean countries, the most common causative agents are Leishmania (L.) major, L. infantum and L. tropica. In Croatia, cutaneous leishmaniasis is a rare disease, the last case being reported in 1988. Our patient was a 5-year-old boy with a left cheek skin lesion in the form of papule with central exulceration, hyperkeratotic crust and erythema of a 6-month duration. The diagnosis of cutaneous leishmaniasis was based on history data (stay in the southernmost region of Croatia and multiple mosquito bites), light microscopic histology (dense infiltrates of large histiocytes with extracellular bodies), and positive Montenegro (leishmanin) test. A new therapy with aminosidine (paromomycin), an aminoglycoside antibiotic, in the form of ointment at a concentration of 20%, was for the first time used in Croatia. Four-week therapy resulted in complete regression of the skin lesions with residual hyperpigmentation. During therapy, no local or systemic side effects were observed. Thus, topical therapy with paromomycin could be considered an efficient therapeutic alternative in the management of cutaneous leishmaniasis.

Controlling the onset of natural cryptosporidiosis in calves with paromomycin sulphate

“…Paromomycin sulphate (synonym: aminosidine sulphate) is the sulphate salt of an antibiotic produced by the growth of Streptomyces chrestomyceticus which has a broad‐spectrum of antimicrobial activity. The compound has received worldwide attention, mainly for its antiprotozoal activity (Nachbaur and others 1997, Neva and others 1997, Berman 1998, Theodos and others 1998, Vexenat and others 1998, Stanimirovic and others 1999, Takur and others 2000), and it has been used to treat difficult cases of cryptosporidiosis in people, with questionable results (Nachbaur and others 1997). In some countries, formulations have been registered for human administration (Humatin; Parke Davis) and for the treatment of leishmaniasis in dogs (Aminofarma; Centralvet‐Vetem).…”

Comparing the efficiency of topical paromomycin with intralesional meglumine antimoniate for cutaneous leishmaniasis

“…(15% paromomycin sulfate and 12% methyl‐benzothenium chloride in soft paraffin). There have been a few conflicting reports evaluating the efficacy of topical paromomycin in the treatment of CL 6–8 . In our comparative study, we found a relative response of 86%.…”

Systematic Review: Re‐emergence of human leishmaniasis in the Balkans

“…Between 1974 and 1993 only 18 CL cases were reported (≈one case per year). During the 1994-2006 period 12 people were infected with CL (≈three cases per year) [19,20]. There is no publicly available information regarding HIV/VL coinfection or leishmaniasis-related deaths in Croatia.…”

“…More than 90% of cases occurred in children below 10 years of age with a mortality rate of 4% [4]. From the 1960s, only sporadic cases were reported [18] as a result of mass insecticide spraying [19]. In total, 70 VL cases were diagnosed between 1954 and 1974 [20], and only 14 cases (6 females and 8 males) from 1975 to 1997 [21].…”