Liposomal amphotericin B in comparison to sodium stibogluconate for Leishmania braziliensis cutaneous leishmaniasis in travelers

J Am Acad Dermatol. 2013 Feb;68(2):284-9. doi: 10.1016/j.jaad.2012.06.014. Epub 2012 Aug 1.


Background: New World cutaneous leishmaniasis is mostly acquired in the Amazon Basin of Bolivia where L viannia (V) braziliensis is endemic. Treatment with systemic pentavalent antimonial compounds has been shown to be effective in achieving clinical cure in only 75% of cases.

Objective: We sought to assess the efficacy and safety of liposomal amphotericin B (L-AmB) treatment for primary infection of cutaneous L (V) braziliensis.

Methods: A prospective observational evaluation was performed for cutaneous leishmaniasis due to L (V) braziliensis which was treated with L-AmB, 3 mg/kg, for 5 consecutive days, and a sixth dose on day 10. This therapy regimen was compared with the treatment regimen of sodium stibogluconate (SSG) 20 mg/kg for 3 weeks.

Results: Our study was divided into two groups; 34 patients received L-AmB and 34 received SSG treatment. Almost all patients were infected in Bolivia. In the L-AmB group, 29 patients (85%) had complete cure compared with 70% in the SSG group (P = not significant), 4 other patients were slow healers, and only one patient needed additional treatment with SSG. No relapses were seen during a mean 29-month follow-up period. Failure rate was 3% in the L-AmB versus 29% in the SSG group (P = .006). Treatment was interrupted in 65% of patients taking SSG because of adverse events, whereas all patients receiving L-AmB completed treatment.

Limitations: This was a non-blinded comparative study.

Conclusions: Comparison of L-Amb to SSG treatment for L (V) braziliensis shows that the former is effective, better tolerated, and more cost effective. L-AmB should therefore be considered as the first-line treatment option for cutaneous L (V) braziliensis infection.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Amphotericin B / administration & dosage*
  • Amphotericin B / economics
  • Antimony Sodium Gluconate / administration & dosage*
  • Antiprotozoal Agents / administration & dosage*
  • Bolivia
  • Female
  • Humans
  • Insurance, Health, Reimbursement
  • Israel / ethnology
  • Leishmania braziliensis*
  • Leishmaniasis, Cutaneous / drug therapy*
  • Male
  • Treatment Outcome


  • Antiprotozoal Agents
  • liposomal amphotericin B
  • Amphotericin B
  • Antimony Sodium Gluconate