Treatment of Complex Cutaneous Leishmaniasis with Liposomal Amphotericin B.

complex cutaneous leishmaniasis cutaneous leishmaniasis leishmania liposomal amphotericin B systemic therapy

Journal

Pathogens (Basel, Switzerland)
ISSN: 2076-0817
Titre abrégé: Pathogens
Pays: Switzerland
ID NLM: 101596317

Informations de publication

Date de publication:
28 Sep 2021
Historique:
received: 05 08 2021
revised: 10 09 2021
accepted: 25 09 2021
entrez: 23 10 2021
pubmed: 24 10 2021
medline: 24 10 2021
Statut: epublish

Résumé

There is no consensus for the best treatment of complex cutaneous leishmaniasis (CL). We aimed to describe a cohort of CL, focusing on liposomal amphotericin B (L-AmB) treatment outcome. We performed a retrospective study in Vall d'Hebron University Hospital (Barcelona, Spain). All patients with parasitologically proven CL diagnosed from 2012 to 2018 were included. The analysis included 41 patients with CL. The median age was 39 years (IQR 12- 66); 12 (29%) were children, and 29 (71%) were men. Regarding treatment, 24 (59%) received local treatment, whereas 17 (41%) had complex CL and were offered intravenous systemic treatment. Sixteen patients received L-AmB; eight (50%) had adverse events, and three (19%) discontinued treatment for safety reasons. All cases were considered cured within the first year post-treatment. L-AmB for complex CL showed no treatment failures, offering an alternative treatment option for patients with complex CL. Clinicians should pay close attention to the potential adverse events of L-AmB and adopt an active drug safety surveillance scheme to rapidly detect reversible side effects.

Sections du résumé

BACKGROUND BACKGROUND
There is no consensus for the best treatment of complex cutaneous leishmaniasis (CL). We aimed to describe a cohort of CL, focusing on liposomal amphotericin B (L-AmB) treatment outcome.
METHODS METHODS
We performed a retrospective study in Vall d'Hebron University Hospital (Barcelona, Spain). All patients with parasitologically proven CL diagnosed from 2012 to 2018 were included.
RESULTS RESULTS
The analysis included 41 patients with CL. The median age was 39 years (IQR 12- 66); 12 (29%) were children, and 29 (71%) were men. Regarding treatment, 24 (59%) received local treatment, whereas 17 (41%) had complex CL and were offered intravenous systemic treatment. Sixteen patients received L-AmB; eight (50%) had adverse events, and three (19%) discontinued treatment for safety reasons. All cases were considered cured within the first year post-treatment.
CONCLUSIONS CONCLUSIONS
L-AmB for complex CL showed no treatment failures, offering an alternative treatment option for patients with complex CL. Clinicians should pay close attention to the potential adverse events of L-AmB and adopt an active drug safety surveillance scheme to rapidly detect reversible side effects.

Identifiants

pubmed: 34684202
pii: pathogens10101253
doi: 10.3390/pathogens10101253
pmc: PMC8537943
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Maria Ubals (M)

Department of Dermatology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.
Doctoral Programme in Medicine and Translational Research: International Health Track, Facultat de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain.

Pau Bosch-Nicolau (P)

Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Adrián Sánchez-Montalvá (A)

Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Fernando Salvador (F)

Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Gloria Aparicio-Español (G)

Department of Dermatology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.
Facultat de Medicina, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Elena Sulleiro (E)

Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Aroa Silgado (A)

Department of Clinical Microbiology, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Antoni Soriano-Arandes (A)

Department of Paediatrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Maria Espiau (M)

Department of Paediatrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Berta Ferrer (B)

Department of Pathology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Diana Pou (D)

Tropical Medicine and International Health Unit, Drassanes-Vall d'Hebron, PROSICS Barcelona, 08035 Barcelona, Spain.

Begoña Treviño (B)

Tropical Medicine and International Health Unit, Drassanes-Vall d'Hebron, PROSICS Barcelona, 08035 Barcelona, Spain.

Israel Molina (I)

Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Vicente García-Patos (V)

Department of Dermatology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.
Facultat de Medicina, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Classifications MeSH