A RANDOMIZED, PLACEBO-CONTROLLED TRIAL OF A 2-WEEK REGIMEN OF AMINOSIDINE (PAROMOMYCIN) OINTMENT FOR TREATMENT OF CUTANEOUS LEISHMANIASIS IN IRAN

The effect of a two-week regimen of topical aminosidine was investigat ed in a randomized, double-blind, placebo-controlled trial of 251 sele cted Iranian patients with zoonotic cutaneous leishmaniasis. Patients underwent clinical and parasitologic assessment before and 15 (end of therapy), 45, and 105 days after starting the treatment. Aminosidine o intment was safe and well-tolerated, and produced significant reductio ns in the prevalence of parasitologically positive smears on days 15 a nd 105 (but not day 45) after treatment compared with placebo. However , there was no clear clinical benefit at any stage after treatment. We conclude that this twice a day two-week regimen of aminosidine was in adequate to accelerate the recovery of most cases of cutaneous leishma niasis. However, the ointment did show some clear evidence of parasito logic efficacy and should now be studied in longer or more frequent re gimes in an effort to prevent parasitologic relapse and thus promote c linical improvement.