Which alternative medications are used in the treatment of leishmaniasis?

Updated: Feb 18, 2020
  • Author: Craig G Stark, MD, FACP, FFTM, RCPS(Glasg), FISTM; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Orally administered ketoconazole, itraconazole, fluconazole, allopurinol, and dapsone have been examined internationally, but none is as effective as the pentavalent antimony compounds. However, given their minimal adverse effect profile, these agents may be useful in accelerating the cure in patients with cutaneous leishmaniasis that does not progress to mucosal disease and tends to self-resolve.

Dapsone was shown to be effective in most cases of Indian cutaneous leishmaniasis after 6 weeks of therapy. [42]

Ketoconazole has a variable cure rate for New World cutaneous leishmaniasis, depending on the species. One study showed a 89% cure rate for individuals infected with L mexicana compared with 30% for L (Viannia) braziliensis. [29] Efficacy against L (Viannia) panamensis in Panama and L major in Iran and Israel has been demonstrated, whereas no effect was noted against L tropica in India and Turkey. [43]

Fluconazole was reportedly effective against 79% of patients infected with uncomplicated cutaneous leishmaniasis caused by L major in Saudi Arabia. [44]


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