Lack of efficacy of mefloquine in the treatment of new world cutaneous leishmaniasis in Colombia

In a nonblinded, therapeutic trial conducted in Colombia, 1.25-1.5 grams of mefloquine base given as a single oral dose or as 250 mg a day for 5-6 con secutive days was not efficacious in the treatment of New World cutaneous l eishmaniasis. The drug had cured only 30.8 % of patients with leishmaniasis skin lesions by the 10th week after start of therapy as compared with a 27 .9% complete cicatrization rate in historical controls treated with placebo tablets and an 86.3% cicatrization rate in historical controls who receive d meglumine antimoniate, 20 mg/kg/day intramuscularly for 20 days, with no upper limit to daily dose. It is concluded that a single course treatment w ith mefloquine is not indicated as monotherapy in the treatment of Colombia n cutaneous leishmaniasis primarily due to L. panamensis.