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Related Experiment Video

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Interventions for Old World cutaneous leishmaniasis.

Julio Heras-Mosteiro1, Begoña Monge-Maillo, Mariona Pinart

  • 1Department of Preventive Medicine and Public Health & Immunology and Microbiology, Rey Juan Carlos University, Avda. Atenas s/n, Alcorcón, Madrid, Spain, 28922.

The Cochrane Database of Systematic Reviews
|December 2, 2017
PubMed
Summary
This summary is machine-generated.

This review found very low-certainty evidence for the effectiveness of itraconazole and paromomycin ointment in treating Old World cutaneous leishmaniasis (OWCL). Both treatments showed increased mild side effects, but conclusions on safety and efficacy remain uncertain.

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Parasitology

Background:

  • Cutaneous leishmaniasis is a significant skin disease in low- and middle-income countries.
  • Old World cutaneous leishmaniasis (OWCL) affects Africa, Asia, the Middle East, Mediterranean, and India.
  • Spontaneous healing necessitates justification for OWCL treatments.

Purpose of the Study:

  • To evaluate therapeutic interventions for localized Old World cutaneous leishmaniasis.
  • To update previous Cochrane Review findings from 2008.

Main Methods:

  • Conducted an updated systematic search of multiple databases up to November 2016.
  • Included randomized controlled trials (RCTs) comparing treatments against placebo, vehicle, or other active compounds.
  • Assessed 89 studies involving 10,583 participants with OWCL.

Main Results:

  • Oral itraconazole showed a potential benefit over placebo for cure, but with very low certainty evidence.
  • Paromomycin ointment demonstrated no significant difference in cure rates compared to vehicle.
  • Both interventions led to more mild adverse effects, with very low certainty evidence for safety conclusions.

Conclusions:

  • Very low-certainty evidence exists for the efficacy of itraconazole and paromomycin ointment in treating OWCL.
  • Conclusions on treatment safety are limited due to insufficient evidence.
  • There is a need for large, well-designed international studies specifying Leishmania species and evaluating diverse patient populations.