SUCCESSFUL TREATMENT OF NEW-WORLD CUTANEOUS LEISHMANIASIS WITH A COMBINATION OF TOPICAL PAROMOMYCIN METHYLBENZETHONIUM CHLORIDE AND INJECTABLE MEGLUMINE ANTIMONATE

Colombian patients with New World cutaneous leishmaniasis were treated with a combination of a topical formulation (15% paromomycin sulfate/5% methylbenzethonium chloride, twice a day) and parenteral meglumine antimonate (20 mg of antimony [Sb]/[kg.d]). Cohort 1 received topical therapy for 10 days and Sb for 7 days; 18 (90%) of the 20 patients were cured (follow-up, 12 months), Other clinical data suggested that neither the topical formulation alone nor the 7-day regimen of Sb alone would have cured many patients, In a subsequent cohort, which received topical therapy for 10 days and Sb for 3 days, the cure rate was 42% (eight of 19 patients), In Colombian cohorts (historical controls) treated with Sb alone for 10-15 days, the cure rate was 31%-36%, Side effects in cohort 1 patients consisted of local reactions to the topical formulation: burning and pruritis in 25% of patients and vesicle formation in 15% of patients, This is the first report that a regimen partially composed of topical antimicrobial agents can be highly effective for treatment of New World cutaneous leishmaniasis.