Comparative study of the efficacy of oral ketoconazole with intra-lesional meglumine antimoniate (Glucantime) for the treatment of cutaneous leishmaniasis.
BACKGROUND
Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease caused by a range of Leishmania species. Many treatment modalities have been proposed, although pentavalent antimonials are still considered to be the first-line treatment of CL. However, due to the high cost and adverse effects of antimonials, as well as an increase in the number of resistant strains of CL to antimonials, this study was conducted to compare the efficacy of oral ketoconazole with intralesional meglumine antimoniate (Glucantime, Specia, Paris, France) for the treatment of CL.


METHODS
A total of 96 patients with CL were enrolled in the study. The diagnosis of CL was confirmed parasitologically using direct skin smears or skin biopsies. The patients were randomly allocated to two treatment groups. Group A (64 patients) was treated with ketoconazole 600 mg/day for adults and 10 mg/kg per day for children for 30 days. Group B (32 patients) was treated with 6-8 biweekly intra-lesional injections of meglumine antimoniate (Glucantime). Both groups were followed for 6 months after termination of treatment.


RESULTS
The results showed complete clinical cure in 89% of cases in Group A (treated with oral ketoconazole) and 72% of cases in Group B (treated with intra-lesional Glucantime). This difference was statistically significant (p < 0.05). No significant side effects were observed in either treatment group.


CONCLUSIONS
Oral ketoconazole can be an effective treatment modality in CL, especially in children afflicted with this disease.
Salmanpour
R
R
Department of Dermatology, Shiraz University of Medical Sciences, Iran.
Handjani
F
F
Nouhpisheh
M K
MK
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007654:Ketoconazole / Q000008:administration & dosage* / Q000009:adverse effects; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D008297:Male; D008536:Meglumine / Q000008:administration & dosage* / Q000009:adverse effects; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage* / Q000009:adverse effects
D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate; D007654:Ketoconazole