Efficacy of miltefosine for Bolivian cutaneous leishmaniasis.

Abstract

Oral miltefosine (2.5 mg/kg/d for 28 days) was compared with intramuscular antimony (20 mg/kg/d for 20 days) in the treatment of cutaneous leishmaniasis caused by Leishmania braziliensis in Palos Blancos, Bolivia. The cure rates with 6 months of follow-up were statistically similar: 36 of 41 evaluable miltefosine patients (88%) versus 15 of 16 (94%) evaluable antimony patients. However, antimony cured more rapidly, because, by 1 month after therapy, 31 of 44 miltefosine patients (70%) compared with 16 of 16 antimony patients (100%) had achieved cure. The two conclusions from this work are that oral miltefosine can be used for cutaneous disease in this part of Bolivia and that miltefosine was more effective for L. braziliensis in this region than for L. braziliensis in Guatemala. Chemotherapy needs to be evaluated in each endemic region, even if the "same" species of Leishmania causes disease in these locales.

• Authors: Jaime Soto, Jaime Rea, Margarita Balderrama, Julia Toledo, Paula Soto, Luis Valda, Jonathan D Berman
• Journal: The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 78 Issue 2 Pg. 210-1 (Feb 2008) ISSN: 0002-9637 [Print] United States
• PMID: 18256415 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Antiprotozoal Agents
• Organometallic Compounds
• Phosphorylcholine
• miltefosine
• Meglumine
• Meglumine Antimoniate

Topics

• Adolescent
• Adult
• Animals
• Antiprotozoal Agents (administration & dosage, adverse effects)
• Bolivia
• Child
• Female
• Humans
• Leishmania braziliensis (drug effects)
• Leishmaniasis, Cutaneous (drug therapy)
• Male
• Meglumine (administration & dosage)
• Meglumine Antimoniate
• Middle Aged
• Organometallic Compounds (administration & dosage)
• Phosphorylcholine (administration & dosage, adverse effects, analogs & derivatives)
• Time Factors
• Treatment Outcome