PARENTERAL AMINOSIDINE IS NOT EFFECTIVE FOR PERUVIAN MUCOCUTANEOUS LEISHMANIASIS

ALEJANDRO LLANOS-CUENTAS Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas. Hospital Nacional Cayetano Heredia. Lima, Peru; Departamento de Medicina, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia; Departamento de Medicina del Hospital Nacional Sur Este, Essalud Cuzco, Perú; Hospital Regional del Cuzco, MINSA, Peru; Facultad de Salud Pública y Administración. Universidad Peruana Cayetano Heredia, Lima, Peru; London School of Hygiene and Tropical Medicine,United Kingdom

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JUAN ECHEVARRIA Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas. Hospital Nacional Cayetano Heredia. Lima, Peru; Departamento de Medicina, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia; Departamento de Medicina del Hospital Nacional Sur Este, Essalud Cuzco, Perú; Hospital Regional del Cuzco, MINSA, Peru; Facultad de Salud Pública y Administración. Universidad Peruana Cayetano Heredia, Lima, Peru; London School of Hygiene and Tropical Medicine,United Kingdom

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CARLOS SEAS Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas. Hospital Nacional Cayetano Heredia. Lima, Peru; Departamento de Medicina, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia; Departamento de Medicina del Hospital Nacional Sur Este, Essalud Cuzco, Perú; Hospital Regional del Cuzco, MINSA, Peru; Facultad de Salud Pública y Administración. Universidad Peruana Cayetano Heredia, Lima, Peru; London School of Hygiene and Tropical Medicine,United Kingdom

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ELSA CHANG Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas. Hospital Nacional Cayetano Heredia. Lima, Peru; Departamento de Medicina, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia; Departamento de Medicina del Hospital Nacional Sur Este, Essalud Cuzco, Perú; Hospital Regional del Cuzco, MINSA, Peru; Facultad de Salud Pública y Administración. Universidad Peruana Cayetano Heredia, Lima, Peru; London School of Hygiene and Tropical Medicine,United Kingdom

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MARIA CRUZ Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas. Hospital Nacional Cayetano Heredia. Lima, Peru; Departamento de Medicina, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia; Departamento de Medicina del Hospital Nacional Sur Este, Essalud Cuzco, Perú; Hospital Regional del Cuzco, MINSA, Peru; Facultad de Salud Pública y Administración. Universidad Peruana Cayetano Heredia, Lima, Peru; London School of Hygiene and Tropical Medicine,United Kingdom

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EUGENIA ALVAREZ Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas. Hospital Nacional Cayetano Heredia. Lima, Peru; Departamento de Medicina, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia; Departamento de Medicina del Hospital Nacional Sur Este, Essalud Cuzco, Perú; Hospital Regional del Cuzco, MINSA, Peru; Facultad de Salud Pública y Administración. Universidad Peruana Cayetano Heredia, Lima, Peru; London School of Hygiene and Tropical Medicine,United Kingdom

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ERNESTO ROSALES Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas. Hospital Nacional Cayetano Heredia. Lima, Peru; Departamento de Medicina, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia; Departamento de Medicina del Hospital Nacional Sur Este, Essalud Cuzco, Perú; Hospital Regional del Cuzco, MINSA, Peru; Facultad de Salud Pública y Administración. Universidad Peruana Cayetano Heredia, Lima, Peru; London School of Hygiene and Tropical Medicine,United Kingdom

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PABLO CAMPOS Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas. Hospital Nacional Cayetano Heredia. Lima, Peru; Departamento de Medicina, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia; Departamento de Medicina del Hospital Nacional Sur Este, Essalud Cuzco, Perú; Hospital Regional del Cuzco, MINSA, Peru; Facultad de Salud Pública y Administración. Universidad Peruana Cayetano Heredia, Lima, Peru; London School of Hygiene and Tropical Medicine,United Kingdom

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ANTHONY BRYCESON Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas. Hospital Nacional Cayetano Heredia. Lima, Peru; Departamento de Medicina, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia; Departamento de Medicina del Hospital Nacional Sur Este, Essalud Cuzco, Perú; Hospital Regional del Cuzco, MINSA, Peru; Facultad de Salud Pública y Administración. Universidad Peruana Cayetano Heredia, Lima, Peru; London School of Hygiene and Tropical Medicine,United Kingdom

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Few therapeutic options are available for mucocutaneous leishmaniasis (MCL). We conducted a randomized open trial to evaluate the efficacy, safety, and tolerance of parenteral aminosidine sulphate (AS) 14 mg/kg/d for 21 days compared with intravenous meglumine antimonate (MA) 20 mg/kg/d for 28 days in patients with moderate MCL in Cuzco, Peru. Cure was defined as complete healing with re-epithelialization within 1 year of follow-up. The trial was stopped after 38 patients were enrolled (17 in the MA group and 21 in the AS group) because of marked differences in response. Study groups were comparable in baseline characteristics. Cure rates were 0/21 in the AS group compared with 8/17 (47%, 95% confidence interval: 23–71%) in the MA group (P < 0.001). Side effects and laboratory abnormalities were mild in both groups. We conclude that parenteral AS given on its own is not effective for MCL in Peru.

Author Notes

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