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 wer e cured (follow-up, 12 months), Other clinical data suggested that nei ther the topical formulation alone nor the 7-day regimen of Sb alone w ould 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) trea ted with Sb alone for 10-15 days, the cure rate was 31%-36%, Side effe cts in cohort 1 patients consisted of local reactions to the topical f ormulation: burning and pruritis in 25% of patients and vesicle format ion in 15% of patients, This is the first report that a regimen partia lly composed of topical antimicrobial agents can be highly effective f or treatment of New World cutaneous leishmaniasis.