Weekly versus every 3 days intralesional meglumine antimoniate therapy for cutaneous leishmaniasis

Abstract

BACKGROUND: Meglumine antimoniate (MA) is an expensive and toxic drug which is still considered as the cornerstone in chemotherapy of cutaneous leishmaniasis in some areas of the world. OBJECTIVE: This study was conducted to evaluate the efficacy of weekly versus every 3 days intralesional MA therapy for cutaneous leishmaniasis. METHODS: The patients were divided into two groups: 35 patients were treated every 3 days and 17 were treated weekly. All lesions were injected with MA from four points surrounding and beneath the lesions until complete blanching was achieved. Injections were repeated every 3 days for the first group and every 7 days for the second group. RESULTS: Of the 35 patients treated every 3 days, receiving six injections, 34 recovered after an average of 18 days. Of the 17 patients treated weekly, receiving three injections, 16 recovered after an average 21 days. CONCLUSIONS: There was little difference in the course and cure rate between the every 3 day and the weekly intra-lesional therapy protocols, while the every 3 day protocol was almost twice as expensive from all aspects (drug, facilities and manpower costs) as the weekly protocol. We therefore recommend an interval of not less than 1 week between injections for intralesional MA treatment of cutaneous leishmaniasis.

Key Words:

• Leishmaniasis
• Meglumine antimoniate
• Therapy