Itraconazole in the treatment of New World mucocutaneous leishmaniasis
Manuel Calvopina1, Angel G Guevara, Rodrigo X Armijos
1Department of Clinical Investigations, Hospital Vozandes, Quito, Ecuador. mcalvopina@hotmail.com <mcalvopina@hotmail.com>
Background:
A well-tolerated oral drug is required for the treatment of mucocutaneous leishmaniasis (MCL). Current parenteral treatment regimens with pentavalent antimonials are associated with marked toxicity and significant rates of relapse.
Aim:
To evaluate the efficacy and tolerability of high-dose itraconazole for the treatment of MCL.
Methods:
An uncontrolled treatment study was performed in 13 Ecuadorian patients with MCL. Each patient received a daily dosage of 400 mg of itraconazole for a minimum of 3 months.
Results:
All 13 subjects responded to itraconazole during the first month of treatment, but by 12 months after treatment the complete resolution of MCL lesions was observed in only three (23%) subjects. No adverse effects of treatment were reported. Response to treatment was associated with a short evolution of the disease and mild to moderate disease severity.
Conclusion:
Prolonged and high-dose treatment regimens with itraconazole are not effective for the treatment of the majority of patients with MCL.
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Antiprotozoal Agents
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