Failure of fluconazole in treating cutaneous leishmaniasis caused by Leishmania guyanensis in the Brazilian Amazon: An open, nonrandomized phase 2 trial

PLoS Neglected Tropical Diseases
Valeska Albuquerque FrancesconiMaria das Graças Costa Alecrim

Abstract

The treatment of Leishmaniasis caused by Leishmania (Viannia) guyanensis is based on a weak strength of evidence from very few clinical trials and some case series reports. Current treatment guidelines recommend pentamidine isethionate or meglumine antimoniate (Glucantime) as the first-line choices. Both are parenteral drugs with a low therapeutic indexes leading to a high risk of undesired effects. Imidazole derivatives interfere with the production of leishmanial ergosterol, an essential component of their membrane structure. One drug that has been studied in different clinical presentations of Leishmania is fluconazole, a hydrophilic bis-triazole, which is easily absorbed through the oral route with a low toxicity profile and is considered safe for children. This drug is readily available in poor countries with a reasonable cost making it a potential option for treating leishmaniasis. An adaptive nonrandomized clinical trial with sequential groups with dose escalation of oral fluconazole was designed to treat adult men with localized cutaneous leishmaniasis (LCL) in Manaus, Brazil. Eligible participants were patients with LCL with confirmed Leishmania guyanensis infection. Twenty adult male patients were treated with 450 mg ...Continue Reading

References

Aug 1, 1990·The American Journal of Medicine·R E SaenzJ D Berman
Jan 1, 1986·Clinical and Experimental Dermatology·D S Jolliffe
Jan 1, 1986·Transactions of the Royal Society of Tropical Medicine and Hygiene·J P DedetG Lalande
May 1, 1981·The American Journal of Tropical Medicine and Hygiene·J D Berman
Aug 31, 1996·Lancet·S SundarH W Murray
Jan 1, 1996·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·R D Pearson, A Q Sousa
Feb 17, 2001·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·V S AmatoV A Neto
Apr 17, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·G A RomeroV de Oliveira Macêdo
Mar 22, 2002·The New England Journal of Medicine·Abdulrahman A AlrajhiJames H Maguire
Sep 11, 2004·International Journal of Dermatology·Manuel CalvopinaPhilip J Cooper
Mar 23, 2010·Journal of the American Academy of Dermatology·Panagiotis MitropoulosMindy Durkin-Konidas
Aug 11, 2010·The Australasian Journal of Dermatology·Angelo V SklavosAlan B Watson
Mar 17, 2011·PLoS Neglected Tropical Diseases·Jorge Augusto de Oliveira GuerraLuiz Carlos de Lima Ferreira
Sep 6, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Anastácio Q SousaMargarida M L Pompeu
Jan 13, 2012·The Journal of Infectious Diseases·Luisa Consuelo RubianoNancy Gore Saravia
Aug 25, 2012·Trials·John A KairallaKeith E Muller
Jan 15, 2013·Transactions of the Royal Society of Tropical Medicine and Hygiene·Gustavo A S RomeroElza F Noronha
Apr 5, 2013·PLoS Neglected Tropical Diseases·Piero OlliaroJorge Alvar
Nov 3, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Fernanda V de O PratesPaulo R L Machado
Dec 13, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Naomi AronsonAlan Magill
Mar 8, 2017·Tropical Medicine and Health·Stephane SimonPierre Couppie

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Citations

Aug 14, 2019·The American Journal of Tropical Medicine and Hygiene·Oscar Daniel Salvioni RecaldeCeleste Vega Gómez
Dec 6, 2018·Revista Da Sociedade Brasileira De Medicina Tropical·Jamyra Iglesias CataldoMaria de Fátima Madeira

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