Treatment of Old World cutaneous leishmaniasis by pentamidine isethionate. An open study of 11 patients.
BACKGROUND
Pentavalent antimonial derivatives (PAD), especially meglumine antimoniate (Glucantime((R))), are usually considered as the first-line drugs for Old World leishmaniasis, but their potential toxicity and the number of required injection, either intralesional or intramuscular, prompt to search for alternative treatments.


OBJECTIVE
To evaluate the efficiency and tolerance of pentamidine isethionate in Old World leishmaniasis.


METHODS
An open pilot study included 11 patients from two regional academic centers, with varied parasitological forms of Old World leishmaniasis, treated with three strictly intramuscular injections of 4 mg/kg of base-pentamidine every other day.


RESULTS
Tolerance was good overall, and 8/11 (73%) of patients responded well with a quick healing of their lesions, little scarring and no relapse.


CONCLUSIONS
Pentamidine isethionate is a safe and effective first-line treatment for Old World leishmaniasis. Larger-scale prospective studies comparing several dosage regimens of pentamidine and pentamidine isethionate to PAD are warranted.
Hellier
I
I
Department of Dermatology-Phlebology, CHRU Montpellier, France.
Dereure
O
O
Tournillac
I
I
Pratlong
F
F
Guillot
B
B
Dedet
J P
JP
Guilhou
J J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000981:Antiprotozoal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010419:Pentamidine / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D011446:Prospective Studies
D000981:Antiprotozoal Agents; D010419:Pentamidine