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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: firstname.lastname@example.org and email@example.com. Andrea Ajata, Carmelo Luque, and Carlos Tintaya, Servicio Departamental de Salud, Departamento de La Paz, La Paz, Bolivia, E-mails: firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org. Daniela Rivero, Hospital Dermatológico de Jorochito, Santa Cruz, Bolivia, E-mail: email@example.com. Jonathan Berman, AB foundation, North Bethesda, MD, E-mail: firstname.lastname@example.org.