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Low dose systemic or intralesional meglumine antimoniate treatment for American tegumentary leishmaniasis results in low lethality, low incidence of relapse, and low late mucosal involvement in a referral centre in Rio de Janeiro, Brazil (2001-2013)
BACKGROUND: American tegumentary leishmaniasis (ATL) is a non-lethal parasitic disease that presents with cutaneous (CL) and mucosal (ML) clinical forms. ATL treatment aims at healing the lesions and preventing the development of the late mucosal form. Systemic meglumine antimoniate (MA) therapy wit...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Instituto Oswaldo Cruz, Ministério da Saúde
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719553/ https://www.ncbi.nlm.nih.gov/pubmed/29211245 http://dx.doi.org/10.1590/0074-02760160478 |
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author | Brahim, Lucia Regina Valete-Rosalino, Cláudia Maria Antônio, Liliane de Fátima Pimentel, Maria Inês Fernandes Lyra, Marcelo Rosandiski Paes, Luiz Eduardo de Carvalho da Costa, Ananda Dutra Vieira, Iracema Forni Dias, Cristina Maria Giordano Duque, Maria Cristina de Oliveira Marzochi, Mauro Celio de Almeida Schubach, Armando de Oliveira |
author_facet | Brahim, Lucia Regina Valete-Rosalino, Cláudia Maria Antônio, Liliane de Fátima Pimentel, Maria Inês Fernandes Lyra, Marcelo Rosandiski Paes, Luiz Eduardo de Carvalho da Costa, Ananda Dutra Vieira, Iracema Forni Dias, Cristina Maria Giordano Duque, Maria Cristina de Oliveira Marzochi, Mauro Celio de Almeida Schubach, Armando de Oliveira |
author_sort | Brahim, Lucia Regina |
collection | PubMed |
description | BACKGROUND: American tegumentary leishmaniasis (ATL) is a non-lethal parasitic disease that presents with cutaneous (CL) and mucosal (ML) clinical forms. ATL treatment aims at healing the lesions and preventing the development of the late mucosal form. Systemic meglumine antimoniate (MA) therapy with 10-20 mg Sb(5+)/kg/day is the first choice of treatment. However, alternative therapies using 5 mg Sb(5+)/kg/day or intralesional (IL) MA are the usual regimens at the National Institute of Infectious Diseases (NIID), Rio de Janeiro, Brazil. OBJECTIVES: To evaluate lethality and the incidence of relapse and development of late ML in CL patients treated at NIID from 2001 until 2013. METHODS: Data were recovered from records of all ATL patients diagnosed during that period. FINDINGS: Out of 777 patients, 753 were treated with MA (96.9%). Of those, 89.1% received alternative therapy of 9.9% IL and 79.2% systemic 5 mg Sb(5+)/kg/day. Some patients required 1-3 additional courses of treatment, thus making a total of 997 courses; 85.2% of them were subjected to alternative therapies. Lethality was 0.1%, relapse incidence 5.8%, and late ML incidence 0.25%. As a final outcome for the 777 patients, 95.9% were cured, 0.1% died and 4.0% were not able to follow-up. MAIN CONCLUSIONS: Alternative MA schedules resulted in low lethality without increase of relapse or late ML incidence. |
format | Online Article Text |
id | pubmed-5719553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Instituto Oswaldo Cruz, Ministério da Saúde |
record_format | MEDLINE/PubMed |
spelling | pubmed-57195532017-12-11 Low dose systemic or intralesional meglumine antimoniate treatment for American tegumentary leishmaniasis results in low lethality, low incidence of relapse, and low late mucosal involvement in a referral centre in Rio de Janeiro, Brazil (2001-2013) Brahim, Lucia Regina Valete-Rosalino, Cláudia Maria Antônio, Liliane de Fátima Pimentel, Maria Inês Fernandes Lyra, Marcelo Rosandiski Paes, Luiz Eduardo de Carvalho da Costa, Ananda Dutra Vieira, Iracema Forni Dias, Cristina Maria Giordano Duque, Maria Cristina de Oliveira Marzochi, Mauro Celio de Almeida Schubach, Armando de Oliveira Mem Inst Oswaldo Cruz Article BACKGROUND: American tegumentary leishmaniasis (ATL) is a non-lethal parasitic disease that presents with cutaneous (CL) and mucosal (ML) clinical forms. ATL treatment aims at healing the lesions and preventing the development of the late mucosal form. Systemic meglumine antimoniate (MA) therapy with 10-20 mg Sb(5+)/kg/day is the first choice of treatment. However, alternative therapies using 5 mg Sb(5+)/kg/day or intralesional (IL) MA are the usual regimens at the National Institute of Infectious Diseases (NIID), Rio de Janeiro, Brazil. OBJECTIVES: To evaluate lethality and the incidence of relapse and development of late ML in CL patients treated at NIID from 2001 until 2013. METHODS: Data were recovered from records of all ATL patients diagnosed during that period. FINDINGS: Out of 777 patients, 753 were treated with MA (96.9%). Of those, 89.1% received alternative therapy of 9.9% IL and 79.2% systemic 5 mg Sb(5+)/kg/day. Some patients required 1-3 additional courses of treatment, thus making a total of 997 courses; 85.2% of them were subjected to alternative therapies. Lethality was 0.1%, relapse incidence 5.8%, and late ML incidence 0.25%. As a final outcome for the 777 patients, 95.9% were cured, 0.1% died and 4.0% were not able to follow-up. MAIN CONCLUSIONS: Alternative MA schedules resulted in low lethality without increase of relapse or late ML incidence. Instituto Oswaldo Cruz, Ministério da Saúde 2017-12 /pmc/articles/PMC5719553/ /pubmed/29211245 http://dx.doi.org/10.1590/0074-02760160478 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Article Brahim, Lucia Regina Valete-Rosalino, Cláudia Maria Antônio, Liliane de Fátima Pimentel, Maria Inês Fernandes Lyra, Marcelo Rosandiski Paes, Luiz Eduardo de Carvalho da Costa, Ananda Dutra Vieira, Iracema Forni Dias, Cristina Maria Giordano Duque, Maria Cristina de Oliveira Marzochi, Mauro Celio de Almeida Schubach, Armando de Oliveira Low dose systemic or intralesional meglumine antimoniate treatment for American tegumentary leishmaniasis results in low lethality, low incidence of relapse, and low late mucosal involvement in a referral centre in Rio de Janeiro, Brazil (2001-2013) |
title | Low dose systemic or intralesional meglumine antimoniate treatment
for American tegumentary leishmaniasis results in low lethality, low incidence
of relapse, and low late mucosal involvement in a referral centre in Rio de
Janeiro, Brazil (2001-2013) |
title_full | Low dose systemic or intralesional meglumine antimoniate treatment
for American tegumentary leishmaniasis results in low lethality, low incidence
of relapse, and low late mucosal involvement in a referral centre in Rio de
Janeiro, Brazil (2001-2013) |
title_fullStr | Low dose systemic or intralesional meglumine antimoniate treatment
for American tegumentary leishmaniasis results in low lethality, low incidence
of relapse, and low late mucosal involvement in a referral centre in Rio de
Janeiro, Brazil (2001-2013) |
title_full_unstemmed | Low dose systemic or intralesional meglumine antimoniate treatment
for American tegumentary leishmaniasis results in low lethality, low incidence
of relapse, and low late mucosal involvement in a referral centre in Rio de
Janeiro, Brazil (2001-2013) |
title_short | Low dose systemic or intralesional meglumine antimoniate treatment
for American tegumentary leishmaniasis results in low lethality, low incidence
of relapse, and low late mucosal involvement in a referral centre in Rio de
Janeiro, Brazil (2001-2013) |
title_sort | low dose systemic or intralesional meglumine antimoniate treatment
for american tegumentary leishmaniasis results in low lethality, low incidence
of relapse, and low late mucosal involvement in a referral centre in rio de
janeiro, brazil (2001-2013) |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719553/ https://www.ncbi.nlm.nih.gov/pubmed/29211245 http://dx.doi.org/10.1590/0074-02760160478 |
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