Intralesional ciprofloxacin for cutaneous leishmaniasis: Comparison with meglumine antimoniate
Abstract
Objectives: Leishmaniasis is quite commonly encountered in Balochistan. Of all the known treatment modalities, only a few are available at our hospital. We carried out this study in search of an effective and easily available agent.
Methodology:This quasi-experimental study was carried out at Combined Military Hospital Sibi in Balochistan from May to Nov 2010. The gross appearance of non healing ulcers and demonstration of parasite in Giemsa stained smears were used to confirm the diagnosis. Thirty nine patients were enrolled and divided into two groups by non- probability convenience sampling. Eighteen patients (having 30 ulcers) received meglumine antimoniate and 21 patients (having 32 ulcers) received 0.2% ciprofloxacin intralesionally every fifth day till re-epithelialization started, up to a maximum of five doses. Side effects of therapy were checked at every visit. Patients were followed up at one week and subsequently one month after completion of treatment to assess complete clinical healing and regression in size of the scar.
Results:Two ulcers in meglumine antimoniate and five ulcers in ciprofloxacin group did not heal (response rate 93.33% vs. 84.38%, p: 0.273). Those treated with meglumine antimoniate required a lesser number of doses (mean 3.83 and 4.27; p: 0.039). Reduction in scar size was equal in both groups (58.46% and 57.21%; p: 0.087).
Conclusions: Intralesional ciprofloxacin is an effective, cheap and safe treatment for cutaneous leishmaniasis.
Methodology:This quasi-experimental study was carried out at Combined Military Hospital Sibi in Balochistan from May to Nov 2010. The gross appearance of non healing ulcers and demonstration of parasite in Giemsa stained smears were used to confirm the diagnosis. Thirty nine patients were enrolled and divided into two groups by non- probability convenience sampling. Eighteen patients (having 30 ulcers) received meglumine antimoniate and 21 patients (having 32 ulcers) received 0.2% ciprofloxacin intralesionally every fifth day till re-epithelialization started, up to a maximum of five doses. Side effects of therapy were checked at every visit. Patients were followed up at one week and subsequently one month after completion of treatment to assess complete clinical healing and regression in size of the scar.
Results:Two ulcers in meglumine antimoniate and five ulcers in ciprofloxacin group did not heal (response rate 93.33% vs. 84.38%, p: 0.273). Those treated with meglumine antimoniate required a lesser number of doses (mean 3.83 and 4.27; p: 0.039). Reduction in scar size was equal in both groups (58.46% and 57.21%; p: 0.087).
Conclusions: Intralesional ciprofloxacin is an effective, cheap and safe treatment for cutaneous leishmaniasis.
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