A randomized, double-blind study of the efficacy of a 10- or 20-day course of sodium stibogluconate for treatment of cutaneous leishmaniasis in United States military personnel.
The recommended treatment for cutaneous leishmaniasis is pentavalent antimony at a dosage of 20 mg/kg/day for 20 days. Some studies conducted in locales in which Leishmania is endemic have suggested that shorter courses of treatment may be as efficacious. We conducted a randomized, double-blind, placebo-controlled study of 10 versus 20 days of sodium stibogluconate (SSG) in United States military personnel who contracted cutaneous leishmaniasis while serving overseas; 19 patients received SSG for 10 days (and placebo for 10 days), and 19 patients received SSG for 20 days. Cure rates were 100% (19 of 19 patients) in the 10-day group and 95% (18 of 19 patients) in the 20-day group. Side effects were more common among patients who received 20 days of therapy. In this group of otherwise healthy young adults, SSG at a dosage of 20 mg/kg/day for 10 days appears to have been therapeutically equivalent and less toxic than the standard 20-day course.
Division of Infectious Diseases, Walter Reed Army Medical Center, Washington, DC, USA. Gllenn.Wortmann@na.amedd.army.mil
Glenn
G
Wortmann
R Scott
RS
Miller
Charles
C
Oster
Joan
J
Jackson
Naomi
N
Aronson
D000328:Adult; D000967:Antimony Sodium Gluconate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018771:Arthralgia / Q000209:etiology; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D010195:Pancreatitis / Q000209:etiology; D016896:Treatment Outcome; D014481:United States
D000981:Antiprotozoal Agents; D000967:Antimony Sodium Gluconate