Comparison of the effectiveness of two topical paromomycin treatments versus meglumine antimoniate for New World cutaneous leishmaniasis

Armijos, Rodrigo X.; Weigel, M. Margaret; Calvopiña, Manuel; Mancheno, Manuel; Rodríguez, Roberto

doi:10.1016/j.actatropica.2004.03.009

Cited by 89 publications

(74 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the overall sensitivity of urine PCR for the diagnosis of CL was sub-optimal compared with the very sensitive molecular assays on invasively obtained scrapings and biopsies of cutaneous and mucosal lesions, [1][2][3][4][5] the presence of detectable kDNA in the urine may suggest a potential role in categorizing patients as candidates for different therapies, especially given the over-representation of mucosal disease in the group with detectable kDNA in the urine. Given the toxicity associated with currently used parenteral therapies for CL (such as pentavalent antimonials and amphotericin B), 1 , 25 there is a movement toward use of topical therapies such as paromomycin, [26][27][28][29][30] cryo-or thermotherapy, [31][32][33] or intralesional antimonials. [32][33][34] However, patients with detectable kDNA in urine may represent a group of patients with less localized forms of disease that may be most amenable to systemic therapy.…”

Section: Discussionmentioning

confidence: 99%

Polymerase Chain Reaction Detection of Leishmania kDNA from the Urine of Peruvian Patients with Cutaneous and Mucocutaneous Leishmaniasis

Veland¹,

Espinosa²,

Valencia³

et al. 2011

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. We hypothesized that Leishmania kDNA may be present in urine of patients with cutaneous leishmaniasis (CL). Urine samples and standard diagnostic specimens were collected from patients with skin lesions. kDNA polymerase chain reaction (PCR) was performed on samples from patients and 10 healthy volunteers from non-endemic areas. Eighty-six of 108 patients were diagnosed with CL and 18 (21%) had detectable Leishmania Viannia kDNA in the urine. Sensitivity and specificity were 20.9% (95% confidence interval [CI] 12.3-29.5%) and 100%. Six of 8 patients with mucocutaneous involvement had detectable kDNA in urine versus 12 of 78 patients with isolated cutaneous diseaseNo healthy volunteer or patient with an alternate diagnosis had detectable kDNA in urine. Sensitivity of urine PCR is sub-optimal for diagnosis. On the basis of these preliminary data in a small number of patients, detectable kDNA in urine may identify less localized forms of infection and inform treatment decisions.

show abstract

Section: Discussionmentioning

confidence: 99%

Polymerase Chain Reaction Detection of Leishmania kDNA from the Urine of Peruvian Patients with Cutaneous and Mucocutaneous Leishmaniasis

Veland¹,

Espinosa²,

Valencia³

et al. 2011

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

“…Some topical dosage forms studied for CL topical treatment that should be mentioned are a paromomycin (PA) ointment (14), and a PA/urea ointment (15), but no significant cure of the lesions was observed with these treatments. In animals experimentally infected by Leishmania amazonensis or L.major, the activity of formulations containing only PA is usually low (16,17).…”

Section: Introductionmentioning

confidence: 99%

Study of In Vitro Drug Release and Percutaneous Absorption of Fluconazole from Topical Dosage Forms

2010

View full text Add to dashboard Cite

Abstract. The present study aimed to evaluate different dosage forms, emulsions, emulgels, lipogels, and thickened microemulsion-based hydrogel, as fluconazole topical delivery systems with the purpose of determining a formulation with the capacity to deliver the whole active compound and maintain it within the skin so as to be considered a useful formulation either for topical mycosis treatment or as adjuvant in a combined therapy for Cutaneous Leishmaniasis. Propylene glycol and diethyleneglycol monoethyl ether were used for each dosage form as solvent for the drug and also as penetration enhancers. In vitro drug release after application of a clinically relevant dose of each formulation was evaluated and then microemulsions and lipogels were selected for the in vitro penetration and permeation study. Membranes of mixed cellulose esters and full-thickness pig ear skin were used for the in vitro studies. Candida albicans was used to test antifungal activity. A microemulsion containing diethyleneglycol monoethyl ether was found to be the optimum formulation as it was able to deliver the whole contained dose and enhance its skin penetration. Also this microemulsion showed the best performance in the antifungal activity test compared with the one containing propylene glycol. These results are according to previous reports of the advantages of microemulsions for topical administration and they are very promising for further clinical evaluation.

show abstract

“…With MA, the expected clinical cure rate in immunocompetent individuals is 91.7%, as demonstrated in a study undertaken in the same geographical area where the patient became infected. 15 Furthermore, most of the patients infected in the Pacific coastal region of Ecuador will selfcure after a Leishmania infection, as demonstrated in a study where a high number of patients were cured without drug treatment. 16 It is well known that treatment response to antimonials in Leishmania-HIV coinfections tends to be poor (33-82%), 2,17 with a relapse rate of 14-57%, and a high mortality.…”

Section: Discussionmentioning

confidence: 94%

Coinfection of Leishmania guyanensis and Human Immunodeficiency Virus–Acquired Immune Deficiency Syndrome: Report of a Case of Disseminated Cutaneous Leishmaniasis in Ecuador

Calvopiña

Aguirre²,

Cevallos

et al. 2017

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Reported herein is the first case of Leishmania-human immunodeficiency virus (HIV) coinfection in Ecuador. In Ecuador, HIV infections overlap endemic areas of leishmaniasis. Immunosuppression is a wellestablished risk factor for developing severe disease. This is a severe case of a 32-year-old man presenting with disseminated pleomorphic ulcers, papules, and cutaneous plaque-like lesions over his whole body. Numerous amastigotes were observed in both skin scrapings and biopsies. The sequence of the cytochrome b gene confirmed the presence of Leishmania guyanensis. The patient was treated but failed to respond to meglumine antimoniate and amphotericin B. Six months later, the patient died due to bacterial septic shock.

show abstract

Comparison of the effectiveness of two topical paromomycin treatments versus meglumine antimoniate for New World cutaneous leishmaniasis

Cited by 89 publications

References 23 publications

Polymerase Chain Reaction Detection of Leishmania kDNA from the Urine of Peruvian Patients with Cutaneous and Mucocutaneous Leishmaniasis

Polymerase Chain Reaction Detection of Leishmania kDNA from the Urine of Peruvian Patients with Cutaneous and Mucocutaneous Leishmaniasis

Study of In Vitro Drug Release and Percutaneous Absorption of Fluconazole from Topical Dosage Forms

Coinfection of Leishmania guyanensis and Human Immunodeficiency Virus–Acquired Immune Deficiency Syndrome: Report of a Case of Disseminated Cutaneous Leishmaniasis in Ecuador

Contact Info

Product

Resources

About