Healing of Old World cutaneous leishmaniasis in travelers treated with fluconazole: drug effect or spontaneous evolution?

Abstract

The efficacy of fluconazole was evaluated in 35 travelers with parasitologically proven imported Old World cutaneous leishmaniasis (CL). Leishmania major (mainly MON-25) was identified in 15 patients and strongly suspected given the transmission area in 12 of these patients. Daily oral fluconazole (200 mg/day for adults and 2.5 mg/kg/day for children) was prescribed for six weeks. Outcome definition was based on re-epithelialization rate at day 50. Of the 27 L. major-infected patients, 12 (44.4%) were cured. This cure rate is similar to the placebo cure rate from trials in L. major CL in which, as in the present report, the definition of outcome relied exclusively on re-epithelialization. These data question the assumption that oral fluconazole is consistently effective for treatment of CL caused by L. major.

• Authors: Gloria Morizot, Pascal Delgiudice, Eric Caumes, Emmanuel Laffitte, Pierre Marty, Alain Dupuy, Claudine Sarfati, Smain Hadj-Rabia, Herve Darie, Anne-Sophie LE Guern, Afif Ben Salah, Francine Pratlong, Jean-Pierre Dedet, Max Grögl, Pierre A Buffet
• Journal: The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 76 Issue 1 Pg. 48-52 (Jan 2007) ISSN: 0002-9637 [Print] United States
• PMID: 17255228 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antiparasitic Agents
• Fluconazole

Topics

• Adult
• Aged
• Aged, 80 and over
• Animals
• Antiparasitic Agents (adverse effects, therapeutic use)
• Biological Evolution
• Child
• Child, Preschool
• Female
• Fluconazole (adverse effects, therapeutic use)
• Humans
• Infant
• Leishmania (drug effects)
• Leishmaniasis, Cutaneous (drug therapy)
• Male
• Middle Aged
• Travel