TREATMENT OF CUTANEOUS LEISHMANIASIS WITH ANTIMONY - INTRAMUSCULAR VERSUS INTRALESIONAL ADMINISTRATION

The various methods used to treat cutaneous leishmaniasis (CL) have no t given consistent results. The aim of the present study was to compar e the efficacy of a solution of meglumine antimoniate (MA; 85 mg Sb/ml ) given intralesionally (i.l.) with that of the same solution given in tramuscularly (i.m.). Eighty CL patients, with a total of 147 lesions, were randomly allocated into the two treatment groups. Forty were inj ected i.m. with MA (15 mg Sb/kg.day) on 6 days/week until 12 injection s had been given to each. The lesions of the other 40 patients were in filtrated with MA (0.2-0.8 ml/lesion) every other day for 30 days. Aft er 15 days' therapy, none of the lesions on those treated i.m. had ful ly healed (although five lesions showed some improvement) whereas two lesions on those treated i.l. had fully healed and 10 showed good impr ovement. After 30 days, 46 (68%) of the 68 lesions on those treated i. m. had healed completely, 11 (16%) had improved, and five (8%) worsene d. The corresponding values for the 66 lesions on those treated i.l. w ere 48 (73%), 10 (15%) and three (5%). There was no statistically sign ificant difference between the two treatment groups, either in terms o f satisfactory response (lesions fully healed or improved) or unsatisf actory response (lesions unchanged or advanced), when assessed on day 30 (P > 0.5). Intralesional antimony is a rapidly effective, safe and economical method of treating simple CL, particularly in patients with cardiac, liver or renal disease, for whom antimonials are contra-indi cated.