title: Intralesional Pentamidine: A Novel Therapy for Single Lesions of Bolivian Cutaneous Leishmaniasis.
abstract: A novel therapy, intralesional (IL) pentamidine, was compared to intralesional therapy with antimony (ILSb), a World Health Organization-recommended therapy, for single Bolivian Leishmania braziliensis lesions. In Study 1, 90 patients were randomized equally between three injections of ILSb over 5 days, five injections of ILSb over 11 days, and three injections of IL pentamidine (120 μg/mm(2)lesion area [ILPenta-120-3]) over 5 days. Cure rates at 6 months were 57% for ILSb-3 injections, 73% for ILSb-5 injections, and 72% for ILPenta-120-3 injections. Adverse effects were local irritation and injection-site pain-ILSb (60 patients): mild (25), moderate (4); IL pentamidine (30 patients): mild (4), moderate (3). In Study 2, 60 patients were randomized equally between five injections of ILSb and three injections of a double dose of IL pentamidine (240 μg/mm(2)[ILPenta-240-3]). In Study 2, cure rates were 67% for ILSb-5 injections and 73% for ILPenta-240-3. For three IL injections of pentamidine, efficacy was optimized at a dose of 120 μg/mm(2)lesion area. The cure rate of that regimen was similar to that for ILSb-5 injections and nonstatistically larger than that of ILSb-3 injections. IL pentamidine is an attractive alternative to ILSb on the basis of efficacy for Bolivian L. braziliensis, the threat of Sb-resistant parasites, tolerance, and patient convenience of three visits over 5 days.
authors.affiliation: Fundación Nacional de Dermatología (FUNDERMA), Santa Cruz, Bolivia; Hospital Dermatológico de Jorochito, Santa Cruz, Bolivia; Hospital Local, Palos Blancos, Bolivia; Centro de Investigaciones Bioclínicas de la Fundación Fader (FADER-CIBIC), Bogota, Colombia; AB Foundation, North Bethesda, Maryland jaime.soto@infoleis.com.
authors.forename: Jaime
authors.initials: J
authors.lastname: Soto
authors.affiliation: Fundación Nacional de Dermatología (FUNDERMA), Santa Cruz, Bolivia; Hospital Dermatológico de Jorochito, Santa Cruz, Bolivia; Hospital Local, Palos Blancos, Bolivia; Centro de Investigaciones Bioclínicas de la Fundación Fader (FADER-CIBIC), Bogota, Colombia; AB Foundation, North Bethesda, Maryland.
authors.forename: David
authors.initials: D
authors.lastname: Paz
authors.affiliation: Fundación Nacional de Dermatología (FUNDERMA), Santa Cruz, Bolivia; Hospital Dermatológico de Jorochito, Santa Cruz, Bolivia; Hospital Local, Palos Blancos, Bolivia; Centro de Investigaciones Bioclínicas de la Fundación Fader (FADER-CIBIC), Bogota, Colombia; AB Foundation, North Bethesda, Maryland.
authors.forename: Daniela
authors.initials: D
authors.lastname: Rivero
authors.affiliation: Fundación Nacional de Dermatología (FUNDERMA), Santa Cruz, Bolivia; Hospital Dermatológico de Jorochito, Santa Cruz, Bolivia; Hospital Local, Palos Blancos, Bolivia; Centro de Investigaciones Bioclínicas de la Fundación Fader (FADER-CIBIC), Bogota, Colombia; AB Foundation, North Bethesda, Maryland.
authors.forename: Paula
authors.initials: P
authors.lastname: Soto
authors.affiliation: Fundación Nacional de Dermatología (FUNDERMA), Santa Cruz, Bolivia; Hospital Dermatológico de Jorochito, Santa Cruz, Bolivia; Hospital Local, Palos Blancos, Bolivia; Centro de Investigaciones Bioclínicas de la Fundación Fader (FADER-CIBIC), Bogota, Colombia; AB Foundation, North Bethesda, Maryland.
authors.forename: Jorge
authors.initials: J
authors.lastname: Quispe
authors.affiliation: Fundación Nacional de Dermatología (FUNDERMA), Santa Cruz, Bolivia; Hospital Dermatológico de Jorochito, Santa Cruz, Bolivia; Hospital Local, Palos Blancos, Bolivia; Centro de Investigaciones Bioclínicas de la Fundación Fader (FADER-CIBIC), Bogota, Colombia; AB Foundation, North Bethesda, Maryland.
authors.forename: Julia
authors.initials: J
authors.lastname: Toledo
authors.affiliation: Fundación Nacional de Dermatología (FUNDERMA), Santa Cruz, Bolivia; Hospital Dermatológico de Jorochito, Santa Cruz, Bolivia; Hospital Local, Palos Blancos, Bolivia; Centro de Investigaciones Bioclínicas de la Fundación Fader (FADER-CIBIC), Bogota, Colombia; AB Foundation, North Bethesda, Maryland.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Berman
mesh_terms: D000328:Adult; D000965:Antimony / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D007892:Leishmania braziliensis / Q000187:drug effects*; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D008297:Male; D010419:Pentamidine / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome; D014344:Trypanocidal Agents / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014344:Trypanocidal Agents; D010419:Pentamidine; D000965:Antimony