Healing of Old World cutaneous leishmaniasis in travelers treated with fluconazole: drug effect or spontaneous evolution?
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.
Morizot
Gloria
G
Pôle de Recherche Biomédicale Centre Médical, Institut Pasteur de Paris, Paris, France.
Delgiudice
Pascal
P
Caumes
Eric
E
Laffitte
Emmanuel
E
Marty
Pierre
P
Dupuy
Alain
A
Sarfati
Claudine
C
Hadj-Rabia
Smain
S
Darie
Herve
H
LE Guern
Anne-Sophie
AS
Salah
Afif Ben
AB
Pratlong
Francine
F
Dedet
Jean-Pierre
JP
Grögl
Max
M
Buffet
Pierre A
PA
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
D000977:Antiparasitic Agents; D015725:Fluconazole