title: Healing of Old World cutaneous leishmaniasis in travelers treated with fluconazole: drug effect or spontaneous evolution?
abstract: The efficacy of fluconazole was evaluated in 35 travelers with parasitologically proven imported Old World cutaneous leishmaniasis (CL). Leishmania major (mainly MON-25) was identified in 15 patients and strongly suspected given the transmission area in 12 of these patients. Daily oral fluconazole (200 mg/day for adults and 2.5 mg/kg/day for children) was prescribed for six weeks. Outcome definition was based on re-epithelialization rate at day 50. Of the 27 L. major-infected patients, 12 (44.4%) were cured. This cure rate is similar to the placebo cure rate from trials in L. major CL in which, as in the present report, the definition of outcome relied exclusively on re-epithelialization. These data question the assumption that oral fluconazole is consistently effective for treatment of CL caused by L. major.
authors.affiliation: Pôle de Recherche Biomédicale Centre Médical, Institut Pasteur de Paris, Paris, France.
authors.forename: Gloria
authors.initials: G
authors.lastname: Morizot
authors.forename: Pascal
authors.initials: P
authors.lastname: Delgiudice
authors.forename: Eric
authors.initials: E
authors.lastname: Caumes
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Laffitte
authors.forename: Pierre
authors.initials: P
authors.lastname: Marty
authors.forename: Alain
authors.initials: A
authors.lastname: Dupuy
authors.forename: Claudine
authors.initials: C
authors.lastname: Sarfati
authors.forename: Smain
authors.initials: S
authors.lastname: Hadj-Rabia
authors.forename: Herve
authors.initials: H
authors.lastname: Darie
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: LE Guern
authors.forename: Afif Ben
authors.initials: AB
authors.lastname: Salah
authors.forename: Francine
authors.initials: F
authors.lastname: Pratlong
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Dedet
authors.forename: Max
authors.initials: M
authors.lastname: Grögl
authors.forename: Pierre A
authors.initials: PA
authors.lastname: Buffet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000977:Antiparasitic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005075:Biological Evolution; D002648:Child; D002675:Child, Preschool; D005260:Female; D015725:Fluconazole / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007891:Leishmania / Q000187:drug effects; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D014195:Travel
chemical_list: D000977:Antiparasitic Agents; D015725:Fluconazole