title: Evaluation of treatment with pentamidine for cutaneous leishmaniasis in Suriname.
abstract: BACKGROUND
  In Suriname, pentamidine isethionate (PI) is the only drug available for the treatment of cutaneous leishmaniasis (CL). Recently, local dermatologists have observed an increase in CL patients not responding adequately to the standard doses.
  
  
  METHODS
  In this study, patient compliance to PI treatment was assessed, and its efficacy was evaluated by comparing the clinical criteria and parasitologic load in week 3 of treatment. Skin biopsies were collected before, during and at the end of therapy and tested by quantitative nucleic acid sequence-based amplification.
  
  
  RESULTS
  In total, 67 patients with suspected CL were enrolled during the recruitment period, of which only 23 patients with confirmed CL were followed until the end of treatment. All 23 patients were found to be infected with Leishmania (Viannia) guyanensis. A lower cure rate (76-78%) was estimated than that obtained previously (90%), and only 50% of the recruited CL patients finished the complete treatment schedule.
  
  
  CONCLUSIONS
  As one-half of the CL patients were treated insufficiently, a much shorter treatment protocol should be considered to improve the inadequate follow-up.
authors.affiliation: Koninklijk Instituut voor de Tropen/Royal Tropical Institute, KIT Biomedical Research, Amsterdam, The Netherlands. wfmeide@yahoo.com
authors.forename: Wendy F
authors.initials: WF
authors.lastname: van der Meide
authors.forename: Leslie O A
authors.initials: LO
authors.lastname: Sabajo
authors.forename: Annigje J
authors.initials: AJ
authors.lastname: Jensema
authors.forename: Inge
authors.initials: I
authors.lastname: Peekel
authors.forename: William R
authors.initials: WR
authors.lastname: Faber
authors.forename: Henk D F H
authors.initials: HD
authors.lastname: Schallig
authors.forename: Rudy F M Lai A
authors.initials: RF
authors.lastname: Fat
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D015331:Cohort Studies; D003906:Developing Countries; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D019353:Endemic Diseases; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D007891:Leishmania / Q000302:isolation & purification*; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010419:Pentamidine / Q000008:administration & dosage*; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013532:Suriname / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010419:Pentamidine