TOPICAL PAROMOMYCIN METHYLBENZETHONIUM CHLORIDE PLUS PARENTERAL MEGLUMINE ANTIMONATE AS TREATMENT FOR AMERICAN CUTANEOUS LEISHMANIASIS - CONTROLLED-STUDY

We determined the efficacy of the combination of the topical formulati on 15% paromomycin sulfate/12% methylbenzethonium chloride (MBCL) and a short course (7 days) of parenteral megluminc antimonate (pentavalen t antimony [Sb]) as treatment of American cutaneous leishmaniasis in C olombian patients, Patients were randomly assigned in unequal allocati on (2:1:1:1) to group 1 (topical paromomycin/MBCL plus injectable Sb f or 7 days), group 2 (topical placebo plus injectable Sb for 7 days), g roup 3 (topical paromomycin/MBCL plus injectable Sb for 3 days), and g roup 4 (injectable Sb for 20 days), Cure was defined as complete reepi thelialization of all lesions without relapse, Cure rates among groups were as follows: 58% (34 of 59), group 1; 53% (16 of 30), group 2; 20 % (6 of 30), group 3; and 84% (26 of 31), group 4, Seventy-one percent of the organisms identified to the species level were Leishmania braz iliensis panamensis. We conclude that 10 days of therapy with paromomy cin/MBCL does not augment the response of cutaneous leishmaniasis (pre dominately due to L. braziliensis panamensis) to a short course of tre atment with meglumine antimonate.