Evaluation of treatment with pentamidine for cutaneous leishmaniasis in Suriname.
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.
van der Meide
Wendy F
WF
Koninklijk Instituut voor de Tropen/Royal Tropical Institute, KIT Biomedical Research, Amsterdam, The Netherlands. wfmeide@yahoo.com
Sabajo
Leslie O A
LO
Jensema
Annigje J
AJ
Peekel
Inge
I
Faber
William R
WR
Schallig
Henk D F H
HD
Fat
Rudy F M Lai A
RF
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
D010419:Pentamidine