Mucosal leishmaniasis: the experience of a Brazilian referral center

Abstract

INTRODUCTION

Pentavalent antimonials (Sb^v) are the most commonly used drugs for the treatment of mucosal leishmaniasis (ML), despite their high toxicity and only moderate efficacy. The aim of this study was to report therapeutic responses with different available options for ML.

METHODS

This study was based on a review of clinical records of 35 patients (24 men and 11 women) treated between 2009 and 2015.

RESULTS

The median age of patients was 63 years, and the median duration of the disease was 24 months. Seventeen patients received Sb^v, while nine patients were treated with liposomal amphotericin B (AmB), and another nine patients were treated with fluconazole. Patients treated with AmB received a total median accumulated dose of 2550mg. The mean duration of azole use was 120 days, and the daily dose ranged from 450 to 900mg. At the three-month follow-up visit, the cure rate was 35%, 67%, and 22% for Sb^v, AmB, and azole groups, respectively. At the six-month follow-up visit, the cure rates for Sb^v, AmB, and azole groups were 71%, 78%, and 33%, respectively.

CONCLUSIONS

There is a scarcity of effective ML treatment alternatives, and based on our observations, fluconazole is not a valid treatment option.

Keywords:
Mucosal leishmaniasis; Therapy; Meglumine antimoniate; Amphotericin B; Azole