Journal Article

Miltefosine for New World Cutaneous Leishmaniasis

J. Soto, B. A. Arana, J. Toledo, N. Rizzo, J. C. Vega, A. Diaz, M. Luz, P. Gutierrez, M. Arboleda, J. D. Berman, K. Junge, J. Engel and H. Sindermann

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 9, pages 1266-1272
Published in print May 2004 | ISSN: 1058-4838
Published online May 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/383321
Miltefosine for New World Cutaneous Leishmaniasis

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The oral agent miltefosine has demonstrated a >95% cure rate in Indian visceral leishmaniasis. We performed a large, placebo-controlled study of miltefosine therapy (2.5 mg/kg per day orally for 28 days) against cutaneous leishmaniasis in Colombia and Guatemala. In regions in Colombia where Leishmania vianna panamensis is common, the per-protocol cure rates for miltefosine and placebo were 91% (40 of 44 patients) and 38% (9 of 24). These values are similar to historic values for the antimony standard of care and placebo. In regions in Guatemala where L. v. braziliensis and L. mexicana mexicana are common, the per-protocol cure rates were 53% (20 of 38) for miltefosine and 21% (4 of 19) for placebo. The miltefosine rate was lower than historic antimony cure rates of >90%. Miltefosine was well tolerated. Miltefosine is a useful oral agent against cutaneous leishmaniasis due to L. v. panamensis in Colombia but not against leishmaniasis due to L. v. braziliensis in Guatemala.

Journal Article.  3772 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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