Clinical audit on treatment of mucosal and multiple cutaneous leishmaniasis lesions with pentavalent systemic antimony
Keywords:
Clinical audit, cutaneous leishmaniasisAbstract
Background Cutaneous leishmaniasis is a parasitic disease spread by the female sandfly occurring throughout the Americas from Texas to Argentina, and in the Old World, particularly the Middle East and North Africa. The condition is diagnosed every year in travelers, immigrants, and military personnel. The treatment mainstay is pentavalent antimony (e.g., sodium stibogluconate). Not all patients require treatment; many lesions heal spontaneously. The treatment is usually indicated in mucosal, mucocutaneous and multiple active cutaneous lesions.Methods 30 patients of cutaneous leishmaniasis were included from the dermatology ward. The method of data collection was retrospective. The basis of proposal was local guidelines. The audit type was process. The standard set was “100% patients with mucosal and multiple cutaneous leishmaniasis lesions should be treated with pentavalent systemic antimonials”.Results The result showed 100% compliance with our local guidelines in the analyzed cases.References
Reithinger R, Dujardin JC, Louzir H et al. Cutaneous leishmaniasis. Lancet Infect Dis. 2007;7:581-96.
Ejaz A, Raza N, Din QU, Bux H. Outbreak of cutaneous leishmaniasis in Somniani, Balochistan – implementation of preventive measures for deployed personnel of armed forces. J Pak Assoc Dermatol. 2008;18:220-5.
Saleem K, Rahman A. Comparison of oral itraconazole and intramuscular meglumine antimoniate in the treatment of cutaneous leishmaniasis. J Coll Physicians Surg Pak. 2007;17:713-6.
Emad M, Hayati F, Fallahzadeh MK, Namazi MR. Superior efficacy of oral fluconazole 400 mg daily versus oral fluconazole 200 mg daily in the treatment of cutaneous Leishmania major infection: a randomized clinical trial. J Am Acad Dermatol. 2011;64:606-8.
Mendonça MG, de Brito ME, Rodrigues EH et al. Persistence of leishmania parasites in scars after clinical cure of American cutaneous leishmaniasis: is there a sterile cure? J Infect Dis. 2004;189:1018-23.
Unger A, O'Neal S, Machado PR et al. Association of treatment of American cutaneous leishmaniasis prior to ulcer development with high rate of failure in northeastern Brazil. Am J Trop Med Hyg. 2009;80:574-9.
Navin TR, Arana BA, Arana FE et al. Placebo-controlled clinical trial of sodium stibogluconate (Pentostam) versus ketoconazole for treating cutaneous leishmaniasis in Guatemala. J Infect Dis. 1992;165:528-34.
Weigel MM, Armijos RX, Racines RJ et al. Cutaneous leishmaniasis in subtropical Ecuador: popular perceptions, knowledge, and treatment. Bull Pan Am Health Organ. 1994;28:142-55.
Yanik M, Gurel MS, Simsek Z, Kati M. The psychological impact of cutaneous leishmaniasis. Clin Exp Dermatol. 2004;29:464-7.
Markle WH, Makhoul K. Cutaneous leishmaniasis: recognition and treatment. Am Fam Physician. 2004;69:1455-60.
Aronson NE, Wortmann GW, Johnson SC et al. Safety and efficacy of intravenous sodium stibogluconate in the treatment of leishmaniasis: recent U.S. military experience. Clin Infect Dis. 1998;27:1457- 64.