Comparison of meglumine antimoniate and pentamidine for peruvian cutaneous leishmaniasis.
Pentamidine was compared with meglumine antimoniate (Glucantime) for 80 patients with cutaneous leishmaniasis due to Leishmania braziliensis in Peru. Of the 40 patients administered Glucantime (20 mg of antimony [Sb]/kg/day intravenously for 20 days), 31 cured (78%), 6 failed (15%), of which 5 were due to relapse, and 3 were lost to follow-up (7%). Of the 40 patients administered pentamidine (2 mg/kg every other day for seven injections), 14 were cured (35%), 23 failed (58%), and 3 were lost to follow-up (7%). Five pentamidine failures were due to relapse, and 14 failures were due to the presence of parasites two weeks after therapy. Both regimens were well tolerated. Gastrointestinal, musculoskeletal, and total adverse events were not statistically different in either group. Elevations in levels of liver enzymes and pancreatic enzymes were statistically higher in the Glucantime group, but no patient terminated therapy prematurely. In this study, Glucantime was more effective than pentamidine for treatment of L. braziliensis cutaneous leishmaniasis in Peru based on parasitologic as well as clinical criteria.
Andersen
Ellen M
EM
Navy Environmental and Preventive Medicine Unit No. 5, San Diego, California 92136, USA. eandersen@nepmu5.med.navy.mil <eandersen@nepmu5.med.navy.mil>
Cruz-Saldarriaga
Maria
M
Llanos-Cuentas
Alejandro
A
Luz-Cjuno
Maria
M
Echevarria
Juan
J
Miranda-Verastegui
Cesar
C
Colina
Olga
O
Berman
Jonathan D
JD
D000328:Adult; D000818:Animals; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D016773:Leishmaniasis, Cutaneous / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010419:Pentamidine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010568:Peru / Q000453:epidemiology; D016896:Treatment Outcome
D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D010419:Pentamidine; D008536:Meglumine; D000077485:Meglumine Antimoniate