Aronson N, Herwaldt BL, Libman M, Pearson R, Lopez-Velez R, Weina P, Carvalho E, Ephros M, Jeronimo S, Magill A, 2017. Diagnosis and treatment of leishmaniasis: clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Am J Trop Med Hyg 96: 24–45.
Soto J, Paz D, Rivero D, Soto P, Quispe J, Toledo J, Berman J, 2016. Intralesional pentamidine: a novel therapy for single lesions of Bolivian cutaneous leishmaniasis. Am J Trop Med Hyg 94: 852–856.
Soto J et al. 2013. Intralesional antimony for single lesions of bolivian cutaneous leishmaniasis. Clin Infect Dis 56: 1255–1260.
Miltefosine Product Label. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/204684s000lbl.pdf. Accessed August 27, 2018.
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: 107–111.
Andersen EM, Cruz-Saldarriaga M, Llanos-Cuentas A, Luz-Cjuno M, Echevarria J, Miranda-Verastegui C, Colina O, Berman JD, 2005. Comparison of meglumine antimoniate and pentamidine for peruvian cutaneous leishmaniasis. Am J Trop Med Hyg 72: 133–137.
Galvão EL, Rabello A, Cota GF, 2017. Efficacy of azole therapy for tegumentary leishmaniasis: a systematic review and meta-analysis. PLoS One 12: e0186117.
Soto J et al. 2004. Miltefosine for new world cutaneous leishmaniasis. Clin Infect Dis 38: 1266–1272.
Brahim LR et al. 2017. Low dose systemic or intralesional meglumine antimoniate treatment for American tegumentary leishmaniasis results in low lethality, low incidence of relapse, and low late mucosal involvement in a referral centre in Rio de Janeiro, Brazil (2001–2013). Mem Inst Oswaldo Cruz 112: 838–843.
Brito G, Dourado M, Guimarães LH, Meireles E, Schriefer A, de Carvalho EM, Machado PRL, 2017. Oral pentoxifylline associated with pentavalent antimony: a randomized trial for cutaneous leishmaniasis. Am J Trop Med Hyg 96: 1155–1159.
National Institutes of Health, 1999. Common Toxicity Criteria (CTC). Available at: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcv20_4-30-992.pdf. Accessed August 27, 2018.
|Past two years||Past Year||Past 30 Days|
|Full Text Views||494||126||1|
Bolivian cutaneous leishmaniasis due to Leishmania braziliensis was treated with the combination of miltefosine (150 mg/day for 28 days) plus intralesional pentamidine (120 μg/mm2 lesion area on days 1, 3, and 5). Ninety-two per cent of 50 patients cured. Comparison to historic controls at our site suggests that the efficacy of the two drugs was additive. Adverse effects and cost were also additive. This combination may be attractive when a prime consideration is efficacy (e.g., in rescue therapy), avoidance of parenteral therapy, or the desire to treat locally and also provide systemic protection against parasite dissemination.
Financial support: This study was funded by the AB Foundation as a grant to J. S.
Disclosure: One of the authors (J. B.) is an officer of the AB Foundation.
Authors’ addresses: Jaime Soto and Paula Soto, FUNDERMA (Fundación Nacional de Dermatología), Santa Cruz, Bolivia, E-mails: email@example.com and firstname.lastname@example.org. Andrea Ajata, Carmelo Luque, and Carlos Tintaya, Servicio Departamental de Salud, Departamento de La Paz, La Paz, Bolivia, E-mails: email@example.com, firstname.lastname@example.org, and email@example.com. Daniela Rivero, Hospital Dermatológico de Jorochito, Santa Cruz, Bolivia, E-mail: firstname.lastname@example.org. Jonathan Berman, AB foundation, North Bethesda, MD, E-mail: email@example.com.