EFFICACY OF A SHORT-COURSE (10 DAYS) OF HIGH-DOSE MEGLUMINE ANTIMONATE WITH OR WITHOUT INTERFERON-GAMMA IN TREATING CUTANEOUS LEISHMANIASISIN GUATEMALA

Sixty-six Guatemalan men with parasitologically confirmed cutaneous le ishmaniasis, due most commonly to Leishmania braziliensis, were random ly assigned to receive one of three treatment regimens: meglumine anti monate (meglumine) for 20 days; meglumine for 10 days; and meglumine f or 10 days plus alternate-day injections of interferon-gamma. In each group, meglumine was given intravenously as 20 mg of antimony/(kg of b ody weight.d). All treatment regimens were associated with similar res ponse rates: the lesions of 19 (90%) of 21 patients who received meglu mine for 20 days, 18 (90%) of 20 patients who received meglumine for 1 0 days, and all 22 patients who received meglumine plus interferon-gam ma were completely reepithelialized by 13 weeks. In addition, for pati ents receiving all treatment regimens, test-of-cure cultures for Leish mania were negative and reactivation of lesions did not occur during 1 2 months of followup. The high efficacy of our 10-day course of meglum ine indicates that the currently recommended duration of 20 days may b e unnecessary for infections caused by L. braziliensis and suggests th at a 10-day course of high-dose antimony should be tested as therapy f or cutaneous leishmaniasis in other geographic areas.