Volume 94, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



A novel therapy, intralesional (IL) pentamidine, was compared to intralesional therapy with antimony (ILSb), a World Health Organization–recommended therapy, for single Bolivian 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 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 [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 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 , the threat of Sb-resistant parasites, tolerance, and patient convenience of three visits over 5 days.


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  1. Soto J, Rojas E, Guzman M, Verduguez A, Nena W, Maldonado M, Cruz M, Gracia L, Villarroel D, Alavi I, Toledo J, Berman J, , 2013. Intralesional antimony for single lesions of Bolivian cutaneous leishmaniasis. Clin Infect Dis 56: 12551260.[Crossref] [Google Scholar]
  2. Berman JD, Wyler DJ, , 1980. An in vitro model for investigation of chemotherapeutic agents in leishmaniasis. J Infect Dis 142: 8386.[Crossref] [Google Scholar]
  3. DNDi, 2015. Anfoleish (CL). Available at: http://www.dndi.org/diseases-projects/portfolio/anfoleish-cl.html?highlight=WyJhbXBob3RlcmljaW4iLCJiIiwiYW1waG90ZXJpY2luIGIiXQ. Accessed July 8, 2015. [Google Scholar]
  4. PubMed search for “Pentamidine and Intralesional” on August 5, 2015. Available at: http://www.ncbi.nlm.nih.gov/pubmed/.
  5. World Health Organization, 2010. Control of the Leishmaniases. WHO Technical Report Series 949. Geneva, Switzerland: WHO. [Google Scholar]
  6. Blum J, Lockwood DNJ, Visser LG, Harms G, Bailey MS, Caumes E, Clerinx J, van Thiel P-P, Morizot G, Hatz C, Buffet PA, , 2012. Local or systemic treatment for New World cutaneous leishmaniasis? Re-evaluating the evidence for the risk of mucosal leishmaniasis. Int Health 4: 153163.[Crossref] [Google Scholar]
  7. Monge-Maillo B, Pérez-Molina JA, Norman FF, López-Vélez R, , 2013. Concerns about topical treatment for New World cutaneous leishmaniasis. Clin Infect Dis 57: 15021503.[Crossref] [Google Scholar]
  8. Soto J, Berman J, , 2013. Reply to Monge-Maillo et al. Clin Infect Dis 57: 15031504.[Crossref] [Google Scholar]
  9. Blum J, Buffet PA, Visser LG, Harms G, Bailey MS, Caumes E, Clerinx J, van Thiel P-P, Morizot G, Hatz C, Dorlo TP, Lockwood DN, , 2014. LeishMan recommendations for treatment of cutaneous and mucosal leishmaniasis in travelers, 2014. J Travel Med 21: 116129.[Crossref] [Google Scholar]
  10. el Darouti MA, al Rubaie SM, , 1990. Cutaneous leishmaniasis. Treatment with combined cryotherapy and intralesional stibogluconate injection. Int J Dermatol 29: 5659.[Crossref] [Google Scholar]
  11. Asilian A, Sadeghinia A, Faghihi G, Momeni A, Amini Harandi A, , 2003. The efficacy of treatment with intralesional meglumine antimoniate alone, compared with that of cryotherapy combined with the meglumine antimoniate or intralesional sodium stibogluconate, in the treatment of cutaneous leishmaniasis. Ann Trop Med Parasitol 97: 493498.[Crossref] [Google Scholar]
  12. Asilian A, Sadeghinia A, Faghihi G, Momeni A, , 2004. Comparative study of the efficacy of combined cryotherapy and intralesional meglumine antimoniate (Glucantime) vs. cryotherapy and intralesional meglumine antimoniate (Glucantime) alone for the treatment of cutaneous leishmaniasis. Int J Dermatol 43: 281283.[Crossref] [Google Scholar]
  13. Salmanpour R, Razmavar MR, Abtahi N, , 2006. Comparison of intralesional meglumine antimoniate, cryotherapy and their combination in the treatment of cutaneous leishmaniasis. Int J Dermatol 45: 11151116.[Crossref] [Google Scholar]
  14. Oliveira-Neto MP, Schubach A, Mattos M, da Costa SC, Pirmez C, , 1997. Intralesional therapy of American cutaneous leishmaniasis with pentavalent antimony in Rio de Janeiro, Brazil: an area of Leishmania (V.) braziliensis transmission. Int J Dermatol 36: 463468.[Crossref] [Google Scholar]
  15. Vasconcellos E de C, Pimentel MI, Schubach A de O, de Oliveira R de V, Azeredo-Coutinho RB, Silva F da C, Salgueiro M de M, Moreira JS, Madeira M de F, Baptista C, Valete-Rosalino CM, , 2012. Intralesional meglumine antimoniate for treatment of cutaneous leishmaniasis patients with contraindication to systemic therapy from Rio de Janeiro (2000 to 2006). Am J Trop Med Hyg 87: 257260.[Crossref] [Google Scholar]
  16. Soto J, Buffet P, Grogl M, Berman J, , 1994. Successful treatment of Colombian cutaneous leishmaniasis with four injections of pentamidine. Am J Trop Med Hyg 50: 107111. [Google Scholar]
  17. Grögl M, Oduola AM, Cordero LD, Kyle DE, , 1989. Leishmania spp.: development of pentostam-resistant clones in vitro by discontinuous drug exposure. Exp Parasitol 69: 7890.[Crossref] [Google Scholar]
  18. Miranda-Verastegui C, Tulliano G, Gyorkos TW, Calderon W, Rahme E, Ward B, Cruz M, Llanos-Cuentas A, Matlashewski G, , 2009. First-line therapy for human cutaneous leishmaniasis in Peru using the TLR7 agonist imiquimod in combination with pentavalent antimony. PLoS Negl Trop Dis 3: e491.[Crossref] [Google Scholar]
  19. Vélez I, López L, Sánchez X, Mestra L, Rojas C, Rodríguez E, , 2010. Efficacy of miltefosine for the treatment of American cutaneous leishmaniasis. Am J Trop Med Hyg 83: 351356.[Crossref] [Google Scholar]
  20. Machado PR, Ampuero J, Guimarães LH, Villasboas L, Rocha AT, Schriefer A, Sousa RS, Talhari A, Penna G, Carvalho EM, , 2010. Miltefosine in the treatment of cutaneous leishmaniasis caused by Leishmania braziliensis in Brazil: a randomized and controlled trial. PLoS Negl Trop Dis 4: e912.[Crossref] [Google Scholar]
  21. Chrusciak-Talhari A, Dietze R, Chrusciak Talhari C, da Silva RM, Gadelha Yamashita EP, de Oliveira Penna G, Lima Machado PR, Talhari S, , 2011. Randomized controlled clinical trial to access efficacy and safety of miltefosine in the treatment of cutaneous leishmaniasis caused by Leishmania (Viannia) guyanensis in Manaus, Brazil. Am J Trop Med Hyg 84: 255260.[Crossref] [Google Scholar]
  22. Newlove T, Guimarães LH, Morgan DJ, Alcântara L, Glesby MJ, Carvalho EM, Machado PR, , 2011. Antihelminthic therapy and antimony in cutaneous leishmaniasis: a randomized, double-blind, placebo-controlled trial in patients co-infected with helminths and Leishmania braziliensis . Am J Trop Med Hyg 84: 551555.[Crossref] [Google Scholar]
  23. Hadighi R, Boucher P, Khamesipour A, Meamar AR, Roy G, Ouellette M, Mohebali M, , 2007. Glucantime-resistant Leishmania tropica isolated from Iranian patients with cutaneous leishmaniasis are sensitive to alternative antileishmania drugs. Parasitol Res 101: 13191322.[Crossref] [Google Scholar]
  24. Yardley V, Ortuno N, Llanos-Cuentas A, Chappuis F, Doncker SD, Ramirez L, Croft S, Arevalo J, Adaui V, Bermudez H, Decuypere S, Dujardin JC, , 2006. American tegumentary leishmaniasis: is antimonial treatment outcome related to parasite drug susceptibility? J Infect Dis 194: 11681175.[Crossref] [Google Scholar]

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  • Received : 02 Sep 2015
  • Accepted : 21 Dec 2015
  • Published online : 06 Apr 2016

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