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Pentamidine was compared with meglumine antimoniate (Glucantime) for 80 patients with cutaneous leishmaniasis due to Leishmania braziliensis in Peru. Of the 40 patients administered Glucantime (20 mg of antimony [Sb]/kg/day intravenously for 20 days), 31 cured (78%), 6 failed (15%), of which 5 were due to relapse, and 3 were lost to follow-up (7%). Of the 40 patients administered pentamidine (2 mg/kg every other day for seven injections), 14 were cured (35%), 23 failed (58%), and 3 were lost to follow-up (7%). Five pentamidine failures were due to relapse, and 14 failures were due to the presence of parasites two weeks after therapy. Both regimens were well tolerated. Gastrointestinal, musculoskeletal, and total adverse events were not statistically different in either group. Elevations in levels of liver enzymes and pancreatic enzymes were statistically higher in the Glucantime group, but no patient terminated therapy prematurely. In this study, Glucantime was more effective than pentamidine for treatment of L. braziliensis cutaneous leishmaniasis in Peru based on parasitologic as well as clinical criteria.
Received July 8, 2004. Accepted for publication September 8, 2004.
Acknowledgments: We thank a number of people that were essential in the completion of this project. We are especially grateful to Maria Julieta Tupayachi Muñiz, Janeath Pancorbo Castilla, Dina T.Terrazas Cervantes, Emilio Ponce de Leon Villacorta, Vilma Corazao Teves, Armando Silva Chaparro, and Maria Teresa Ruiz Degauna (Cusco, Peru); Carmen Lucas and Carola Salas (Parasitology Laboratory of the Naval Medical Research Center Detachment, Lima, Peru) and Dr. Mark Bonner (Walter Reed Army Institute of Research, Silver Spring, MD).
Financial support: This work was supported by United States Navy Work Unit Number no. 100401 000 9MPE B0018.
Disclaimer: The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official or reflecting the views of the Navy Department or the naval service at large.
Authors’ addresses: Ellen M. Andersen, Navy Environmental and Preventive Medicine Unit No. 5, Naval Station, 3235 Albacore Alley, San Diego, CA 92136, Maria Cruz-Saldarriaga, Hospital Instituto Peruano Seguro Social, Cusco, Peru. Alejandro Llanos Cuentas, Juan Echevarria, and Cesar Miranda-Verastegui, Universidad Peruana Cayetano Heredia, Casilla Postal 4314, Lima 100, Peru. Maria Luz Cjuno and Olga Colina, Naval Medical Research Center Detachment, Unit 3800, APO AA, 34031, Lima, Peru. Jonathan D. Berman, National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, MD 20892, E-mail: JBe9320457{at}aol.com.
Reprint requests: Ellen M. Andersen, Navy Environmental and Preventive Medicine Unit No. 5, Naval Station, 3235 Albacore Alley, San Diego, CA 92136, E-mail: eandersen{at}nepmu5.med.navy.mil.
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