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

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 2...

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Bibliographic Details
Published in:Revista do Instituto de Medicina Tropical de São Paulo 2000-12, Vol.42 (6), p.321-325
Main Authors: Oliveira-Neto, M P, Mattos, M, Pirmez, C, Fernandes, O, Gonçalves-Costa, S C, Souza, C F, Grimaldi, Jr, G
Format: Article
Language:English
Subjects:
Antimony
Antiprotozoal Agents - administration & dosage
Antiprotozoal Agents - therapeutic use
Female
Follow-Up Studies
Humans
Leishmania (Viannia) braziliensis
Leishmaniasis, Mucocutaneous - drug therapy
Male
Meglumine - administration & dosage
Meglumine - therapeutic use
Meglumine Antimoniate
Middle Aged
Mucosal leishmaniasis
Organometallic Compounds - administration & dosage
Organometallic Compounds - therapeutic use
Polymerase Chain Reaction
Severity of Illness Index
Therapy
Time Factors
TROPICAL MEDICINE
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Summary: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.
ISSN:0036-4665
1678-9946
0036-4665
1678-9946
DOI:10.1590/S0036-46652000000600004