antimony-sodium-gluconate and Pain

Cutaneous leishmaniasis (CL) is generally caused by Leishmania aethiopica in Ethiopia, and is relatively hard to treat. Sodium stibogluconate (SSG) is the only routinely and widely available antileishmanial treatment, and can be used systemically for severe lesions and locally for smaller lesions. There is limited data on the effectiveness of intralesional (IL) SSG for localized CL in Ethiopia and therefore good data is necessary to improve our understanding of the effectiveness of the treatment.. A pragmatic (before and after Quazi experimental) study was done to assess the effectiveness of intralesional SSG among localized CL patients at Boru Meda general hospital, Northeast Ethiopia. Patients who were assigned to intralesional SSG by the treating physician were eligible for this study. Study subjects were recruited between January and August 2021. Infiltration of intralesional SSG was given weekly to a maximum of six doses. However, when a patient's lesions were already cured before getting 6 doses, treatment was not conintued, and patient were only asked to come for lesion assessment. Skin slit smears (SSS) were taken each week until they became negative. Outcomes were assessed at day 90, with patients who had 100% reepithelization (for ulcerative lesions) and/or flattening (for indurated lesions) defined as cured. Multi-level logistic regression was done to assess factors associated with cure. A total of 83 patients were enrolled, and final outcomes were available for 72 (86.75%). From these 72, 43 (59.7%, 95% confidence interval 0.44-0.69) were cured at day 90. Adverse effects were common with 69/72 patients (95.8%) reporting injection site pain. Factors associated with cure were age (OR 1.07 95% CI: 1.07-1.27), being male (OR 1.79, 95% CI: 1.10-2.25), size of the lesion (OR 0.79, 95% CI: 0.078-0.94) and skin slit smear (SSS) result +1 grading (OR 1.53, 95% CI: 1.24-1.73) and +2 grading (OR 1.51, 95% CI: 1.41-3.89) compared to the SSS grade +6.. Our findings revealed that intralesional sodium stibogluconate resulted in a cure rate of around 60%, with almost all patients experiencing injection site pain. This emphasizes the need for local treatment options which are more patient-friendly and have better cure rates.

Topics: Antimony Sodium Gluconate; Antiprotozoal Agents; Ethiopia; Female; Hospitals, General; Humans; Leishmaniasis, Cutaneous; Male; Pain; Treatment Outcome

Topics: Adult; Animals; Antimony Sodium Gluconate; Biopsy; Diagnosis, Differential; Humans; Leishmania braziliensis; Leishmaniasis, Mucocutaneous; Male; Nasal Obstruction; Nose; Nose Diseases; Pain; Trypanocidal Agents

Cutaneous South American leishmaniasis is caused by several species of leishmaniasis. Lack of appropriate treatment may lead to mucocutaneous leishmaniasis, mainly with L. b. braziliensis and L. b. panamensis.. To describe the clinical findings of Israeli travelers infected with cutaneous South American leishmaniasis and to draw attention to this problem.. Ten patients were interviewed, examined and treated.. Twenty-two lesions of cutaneous leishmaniasis were found, all in exposed areas. Patients were seen by an average three physicians (range 1-6) before the final diagnosis was confirmed by direct smear, after an average period of 125 days (range 88-270 days). Treatment with Pentostam was started after an average period of 134 days (range 94-275 days). All lesions healed completely, but with scarring.. Travelers to endemic areas, as well as physicians, should be instructed about the potential risks and the clinical manifestations of cutaneous and mucocutaneous South American leishmaniasis. Such awareness will prevent undue delay in diagnosis and treatment.

Topics: Adult; Animals; Antimony Sodium Gluconate; Antiprotozoal Agents; Female; Headache; Humans; Israel; Leg Ulcer; Leishmania mexicana; Leishmaniasis, Cutaneous; Liver; Liver Function Tests; Male; Meglumine; Meglumine Antimoniate; Muscle Weakness; Muscular Diseases; Organometallic Compounds; Pain; Retrospective Studies; Skin; South America; Travel; Weight Loss

Topics: Antimony Sodium Gluconate; Antiprotozoal Agents; Child; Dermatomyositis; Fever; Humans; Leishmaniasis, Visceral; Male; Pain