Mucosal leishmaniasis: the experience of a Brazilian referral center

Abstract INTRODUCTION Pentavalent antimonials (Sbv) 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 Sbv, 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 Sbv, AmB, and azole groups, respectively. At the six-month follow-up visit, the cure rates for Sbv, 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.

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Main Authors: Pedras,Mariana Junqueira, Carvalho,Janaína de Pina, Silva,Rosiana Estéfane da, Ramalho,Dario Brock, Senna,Maria Camilo Ribeiro de, Moreira,Hugo Silva Assis, Martinho,Lorena Zaine Matos, Rabello,Ana, Cota,Gláucia
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Medicina Tropical - SBMT 2018
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000300318
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spelling oai:scielo:S0037-868220180003003182018-12-04Mucosal leishmaniasis: the experience of a Brazilian referral centerPedras,Mariana JunqueiraCarvalho,Janaína de PinaSilva,Rosiana Estéfane daRamalho,Dario BrockSenna,Maria Camilo Ribeiro deMoreira,Hugo Silva AssisMartinho,Lorena Zaine MatosRabello,AnaCota,Gláucia Mucosal leishmaniasis Therapy Meglumine antimoniate Amphotericin B Azole Abstract INTRODUCTION Pentavalent antimonials (Sbv) 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 Sbv, 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 Sbv, AmB, and azole groups, respectively. At the six-month follow-up visit, the cure rates for Sbv, 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.info:eu-repo/semantics/openAccessSociedade Brasileira de Medicina Tropical - SBMTRevista da Sociedade Brasileira de Medicina Tropical v.51 n.3 20182018-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000300318en10.1590/0037-8682-0478-2017
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countrycode BR
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libraryname SciELO
language English
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author Pedras,Mariana Junqueira
Carvalho,Janaína de Pina
Silva,Rosiana Estéfane da
Ramalho,Dario Brock
Senna,Maria Camilo Ribeiro de
Moreira,Hugo Silva Assis
Martinho,Lorena Zaine Matos
Rabello,Ana
Cota,Gláucia
spellingShingle Pedras,Mariana Junqueira
Carvalho,Janaína de Pina
Silva,Rosiana Estéfane da
Ramalho,Dario Brock
Senna,Maria Camilo Ribeiro de
Moreira,Hugo Silva Assis
Martinho,Lorena Zaine Matos
Rabello,Ana
Cota,Gláucia
Mucosal leishmaniasis: the experience of a Brazilian referral center
author_facet Pedras,Mariana Junqueira
Carvalho,Janaína de Pina
Silva,Rosiana Estéfane da
Ramalho,Dario Brock
Senna,Maria Camilo Ribeiro de
Moreira,Hugo Silva Assis
Martinho,Lorena Zaine Matos
Rabello,Ana
Cota,Gláucia
author_sort Pedras,Mariana Junqueira
title Mucosal leishmaniasis: the experience of a Brazilian referral center
title_short Mucosal leishmaniasis: the experience of a Brazilian referral center
title_full Mucosal leishmaniasis: the experience of a Brazilian referral center
title_fullStr Mucosal leishmaniasis: the experience of a Brazilian referral center
title_full_unstemmed Mucosal leishmaniasis: the experience of a Brazilian referral center
title_sort mucosal leishmaniasis: the experience of a brazilian referral center
description Abstract INTRODUCTION Pentavalent antimonials (Sbv) 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 Sbv, 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 Sbv, AmB, and azole groups, respectively. At the six-month follow-up visit, the cure rates for Sbv, 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.
publisher Sociedade Brasileira de Medicina Tropical - SBMT
publishDate 2018
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000300318
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