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Am. J. Trop. Med. Hyg., 78(2), 2008, pp. 210-211
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Efficacy of Miltefosine for Bolivian Cutaneous Leishmaniasis

Jaime Soto, Jaime Rea, Margarita Balderrama, Julia Toledo, Paula Soto, Luis Valda, AND Jonathan D. Berman*
Fundación FADER, Bogota, Colombia; Puesto de Salud, Campamento OSCAR, Palos Blancos, Bolivia; Hospital de Clínicas, La Paz, Bolivia; and AB Foundation, Rockville, Maryland

 

ABSTRACT

Oral miltefosine (2.5 mg/kg/d for 28 days) was compared with intramuscular antimony (20 mg/kg/d for 20 days) in the treatment of cutaneous leishmaniasis caused by Leishmania braziliensis in Palos Blancos, Bolivia. The cure rates with 6 months of follow-up were statistically similar: 36 of 41 evaluable miltefosine patients (88%) versus 15 of 16 (94%) evaluable antimony patients. However, antimony cured more rapidly, because, by 1 month after therapy, 31 of 44 miltefosine patients (70%) compared with 16 of 16 antimony patients (100%) had achieved cure. The two conclusions from this work are that oral miltefosine can be used for cutaneous disease in this part of Bolivia and that miltefosine was more effective for L. braziliensis in this region than for L. braziliensis in Guatemala. Chemotherapy needs to be evaluated in each endemic region, even if the "same" species of Leishmania causes disease in these locales.

Received June 25, 2007. Accepted for publication October 21, 2007.

Disclosure: J. Berman is an officer of the AB Foundation, the funder of the study. This statement is made in the interest of full disclosure and not because the author considers this to be a conflict of interest.

* Address correspondence to Jonathan D. Berman, 4088 Shape Charge Road, Martinsburg, WV 25401. E-mail: Jbe9320457{at}aol.com

Authors’ addresses: Jaime Soto, Julia Toledo, and Paula Soto, Fundación FADER, Calle 60, A#5-54, Of. 201, Bogota, Colombia. Jaime Rea and Margarita Balderrama, Puesto de Salud, Campamento OSCAR, Palos Blancos, Bolivia. Luis Valda, Hospital de Clínicas, La Paz, Bolivia. Jonathan D. Berman, AB Foundation, 4088 Shape Charge Road, Martinsburg, WV 25401, E-mail: Jbe9320457{at}aol.com.




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