BACKGROUNDAmerican tegumentary leishmaniasis (ATL) is a non-lethal parasitic disease
that presents with cutaneous (CL) and mucosal (ML) clinical forms. ATL
treatment aims at healing the lesions and preventing the development of the
late mucosal form. Systemic meglumine antimoniate (MA) therapy with 10-20 mg
Sb5+/kg/day is the first choice of treatment. However,
alternative therapies using 5 mg Sb5+/kg/day or intralesional
(IL) MA are the usual regimens at the National Institute of Infectious
Diseases (NIID), Rio de Janeiro, Brazil.OBJECTIVESTo evaluate lethality and the incidence of relapse and development of late ML
in CL patients treated at NIID from 2001 until 2013.METHODSData were recovered from records of all ATL patients diagnosed during that
period.FINDINGSOut of 777 patients, 753 were treated with MA (96.9%). Of those, 89.1%
received alternative therapy of 9.9% IL and 79.2% systemic 5 mg
Sb5+/kg/day. Some patients required 1-3 additional courses of
treatment, thus making a total of 997 courses; 85.2% of them were subjected
to alternative therapies. Lethality was 0.1%, relapse incidence 5.8%, and
late ML incidence 0.25%. As a final outcome for the 777 patients, 95.9% were
cured, 0.1% died and 4.0% were not able to follow-up.MAIN CONCLUSIONSAlternative MA schedules resulted in low lethality without increase of
relapse or late ML incidence.