COMPARISON OF ORAL DAPSONE WITH INTRAMUSCULAR MEGLUMINE ANTIMONIATE IN CUTANEOUS LEISHMANIASIS

Authors

  • Najia Ahmed
  • Sadia Malik
  • Moizza Tahir Combined Military Hospital Gujranwala
  • Atiya Rahman
  • Ifrah Fayyaz
  • Naeem Raza
  • Nadia Iftikhar

DOI:

https://doi.org/10.55519/JAMC-04-10265

Keywords:

Cutaneous leishmaniasis, Meglumine antimoniate, Dapsone

Abstract

Background: Many drugs are effective are used as second line treatment for cutaneous leishmaniasis. Dapsone therapy is tolerated well and cost effective. The aim of present study is to determine the efficacy of oral dapsone in comparison with intramuscular meglumine antimoniate in patients with cutaneous leishmaniasis and thus find out an effective second line treatment agent. Methods: This randomized controlled trial was carried out at dermatology department, of tertiary care centre Rawalpindi, Pakistan from November 2017 to June 2018. Hundred biopsy proven patients of cutaneous leishmaniasis completed the study with 50 patients in two group. Group A received intramuscular meglumine antimoniate (15 mg/kg/day). Group B received oral dapsone2.5 mg /kg/body weight /day (200 mg per day). Efficacy of therapeutic response was noted at the end of treatment. Data was analyzed with statistical analysis program (IBM-SPSS V22). Chi-square test was applied to compare efficacy, p value of ≤0.05 was significant. Stratification of data with respect to age, gender, duration of disease, number of lesions and weight was done to see their effect on treatment efficacy. Post stratification chi-square test for both groups was applied (p≤0.05 considered significant). Results: A total of 100 participants took part in the study. Duration of treatment (p-value <0.001) and the efficacy of the drugs (p-value=0.020) were significant. Meglumine antimoniate therapy group displayed a comparatively fast-paced recovery in (21–40 days) whereas Dapsone group showed better recovery in (41–60 days) in their lesions. Conclusion: Dapsone is an effective treatment for cutaneous Leishmaniasis. Results: A total of 100 participants took part in the study. Duration of treatment (p-value <0.001) and the efficacy of the drugs (p-value=0.020)were significant. Meglumine antimoniate therapy group displayed a comparatively fast-paced recovery in (21-40 days) whereas Dapsone group showed better recovery in (41-60days) in their lesions. Conclusion: Dapsone  is an effective   treatment for cutaneous Leishmaniasis  

References

Tahir M, Bashir U, Hafeez J, Ghafoor R. Safety and efficacy of miltefosine in cutaneous leishmaniasis: An open label, non-comparativestudy from Balochistan. Pak J Med Sci 2019;35(20):495–9.

Mokni M. [Cutaneous leishmaniasis]. Ann Dermatol Venereol 2019;146(3):232–46.

Meireles CB, Maia LC, Soares GC, Teodoro IPP, Gadelha MDSV, da Silva CGL, et al. Atypical presentations of cutaneous leishmaniasis: A Systematic review. Acta Trop 2017;172:240–54.

Gurel MS, Tekin B, Uzun S. Cutaneous leishmaniasis: A great imitator. Clin Dermatol 2020;38(2):140–51.

Garrido-Jareño M, Sahuquillo-Torralba A, Chouman-Arcas R, Castro-Hernández I, Molina-Moreno JM, Llavador-Ros M, et al. Cutaneous and mucocutaneous leishmaniasis: experience of a Mediterranean hospital. Parasit Vectors 2020;13(1):24.

Garza-Tovar TF, Sacriste-Hernández MI, Juárez-Durán ER, Arenas R. An overview of the treatment of cutaneous leishmaniasis. Fac Rev. 2020 ;22;9:28. doi: 10.12703/r/9-28.

Galvão EL, Rabello A, Cota GF. Efficacy of azole therapy for tegumentary leishmaniasis: A systematic review and meta-analysis. PLoS One 2017;12(10):e0186117.

Hanif MM, Akram K, Mustafa G. Intralesional Versus Oral Chloroquine in Cutaneous Leishmaniasis: Comparison of Outcome, Duration of Treatment and Total Dose of Drug. J Coll Physicians Surg Pak 2016;26(4):260–2.

Momeni AZ, Reiszadae MR, Aminjavaheri M. Treatment of cutaneous leishmaniasis with a combination of allopurinol and low-dose meglumine antimoniate. Int J Dermatol 2002;41(7):441–3.

Lee SA, Hasbun R. Therapy of cutaneous leishmaniasis. Int J Infect Dis 2003;7(2):86–93.

Dogra J, Lal BB, Misra SN. Dapsone in the treatment of cutaneous leishmaniasis. Int J Dermatol 1986;25(6):398–400.

de Vries HJC, Reedijk SH, Schallig HDFH . Cutaneous Leishmaniasis: Recent Developments in Diagnosis and Management. Am J Clin Dermatol 2015;16(2):99–109.

Pazokia H, Fakhar M, Rasooli A, Karamiand M, Nazar E. Lupoid leishmaniasis among the known cases of cutaneous leishmaniasis in Herat Province, western Afghanistan. J Infect Public Health 2016;9(5):557–63.

Bashir U, Tahir M, Anwar MI, Manzoor F. Comparison of Intralesional Meglumine Antimonite along with oral Itraconazole to Intralesional Meglumine Antimonite in the treatment of Cutaneous Leishmaniasis. Pak J Med Sci 2019;35(6):1669–73.

Wijerathna T, Gunathilaka N, Gunawardena K, Rodrigo W. Socioeconomic, demographic and landscape factors associated with cutaneous leishmaniasis in Kurunegala District, Sri Lanka. Parasit Vectors 2020;13(1):244.

Dogra J. A double-blind study on the efficacy of oral dapsone in cutaneous leishmaniasis. Trans R Soc Trop Med Hyg 1991;85(2):212–3.

Al-Mutairi N, Alshiltawy M, El Khalawany M, Joshi A, Eassa BI, Manchanda Y, et al. Tropical medicine rounds: Treatment of old world cutaneous leishmaniasis with dapsone, itraconazole, cryotherapy and imiquimod, alone and in combination. Int J Dermatol 2009;48(8):862–9.

Osorio LE, Palacios R, Chica ME, Ochoa MT. Treatment of cutaneous leishmaniasis in Colombia with dapsone. Lancet 1998;351(9101):498–9.

Aflatoonian MR, Sharifi I, Aflatoonian B, Bamorovat M, Heshmatkhah A, Babaei Z, et al. Associated-risk determinants for anthroponotic cutaneous leishmaniasis treated with meglumine antimoniate: A cohort study in Iran. PLoS Negl Trop Dis 2019;13(6):e0007423.

Mohammadzadeh M, Behnaz F, Golshan Z. Efficacy of glucantime for treatment of cutaneous leishmaniasis in Central Iran. J Infect Public Health 2013;6(2):120–4.

Dogra J, Lal BB, Misra SN. Cutaneous leishmaniasis:Therapeutic efficacy of Dapsone in the commonly existing sub –types. Indian J Dermatol Venereol Leprol 1989;55(5):375–7.

Romero GAS, Guerra MVDF, Paes MG, Macedo VDO. Comparison of cutaneous leishmaniasis due to leishmania (viannnia)Braziliensis and L. (V.) Guyanensis in Brazil: therapeutic response to Meglumine antimoniate. Am J Trop Med Hyg 2001;65(5):456–65.

Downloads

Published

2022-09-27