Mucosal leishmaniasis ("espundia") responsive to low dose of N-methyl glucamine (Glucantime) in Rio de Janeiro, Brazil

Rev Inst Med Trop Sao Paulo. 2000 Nov-Dec;42(6):321-5. doi: 10.1590/s0036-46652000000600004.

Abstract

Response to treatment with antimonial drugs varies considerably depending on the parasite strain involved, immune status of the patient and clinical form of the disease. Therapeutic regimens with this first line drug have been frequently modified both, in dose and duration of therapy. A regimen of 20 mg/kg/day of pentavalent antimony (Sb5+) during four weeks without an upper limit on the daily dose is currently recommended for mucosal disease ("espundia"). Side-effects with this dose are more marked in elderly patients, more commonly affected by this form of leishmaniasis. According to our experience, leishmaniasis in Rio de Janeiro responds well to antimony and, in cutaneous disease, high cure rates are obtained with 5 mg/kg/day of Sb5+ during 30 to 45-days. In this study a high rate of cure (91.4%) employing this dose was achieved in 36 patients with mild disease in this same geographic region. Side-effects were reduced and no antimony refractoriness was noted with subsequent use of larger dose in patients that failed to respond to initial schedule.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiprotozoal Agents / administration & dosage
  • Antiprotozoal Agents / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Leishmaniasis, Mucocutaneous / drug therapy*
  • Male
  • Meglumine / administration & dosage
  • Meglumine / therapeutic use*
  • Meglumine Antimoniate
  • Middle Aged
  • Organometallic Compounds / administration & dosage
  • Organometallic Compounds / therapeutic use*
  • Polymerase Chain Reaction
  • Severity of Illness Index
  • Time Factors

Substances

  • Antiprotozoal Agents
  • Organometallic Compounds
  • Meglumine
  • Meglumine Antimoniate