Comparison between the Efficacy and Safety of Intralesional Sodium Stibogluconate Solution and Intralesional Metronidazole Solution in the Treatment of Cutaneous Leishmaniasis

Dr. Sedeeq Basheer Younus | Dr. Barzan Khalid Sharaf

Abstract: Background Leishmaniasis encompasses a spectrum of chronic infections in humans and several animal species. It is caused by over 20 species of the genus Leishmania Leishmania is a flagellated protozoa belonging to the order Kinetoplastidae. The cutaneous leishmaniasis is restricted to the skin and is seen more often in the Old World. Transmission is by the bite of infected female sandfly from the genera Phlebotomus and Lutzomyia. The disease has a worldwide distribution, affecting millions of people in South America, Mediterranean basin, and parts of Asia and Africa. There are four major clinical patterns (1) Cutaneous which is restricted to the skin and is seen more often in the Old World. (2) Mucocutaneous which affects both the skin and mucosal surfaces and occurs almost exclusively in the New World. (3) Diffuse cutaneous which occurs mainly in the New World. (4) Visceral which affects the organs of the mononuclear phagocyte system, e. g. liver, spleen. Aim of study To compare the efficacy and safety of Intralesional sodium stibogluconate and Intralesional metronidazole solution in the treatment of cutaneous leishmaniasis. Patients and methods This is a therapeutic trial intervention study done in dermatology and venereology teaching department in Rezgari hospital, Erbil / Iraq, during the period from November, 16th 2015 to November, 16th 2016 on convenient sample of 60 patients. Two typical cutaneous leishmaniasis lesions from each patient had been selected, labelled by writing its number, patient & #039, s full name, type of treatment (sodium stibogluconate solution or metronidazole solution) on a piece of adhesive plaster and putted above or below the lesion, then the lesions is measured by a ruller and documented and then the lesion is photographed by a Samsung mobile camera and all this data had been documented in a handbook for follow up of patients each week until the end of the period of the study. During each visit the perilesional area of one of the lesion is sterilized by povidone iodine 10 % and theno.2ml of sodium stibogluconate solution (pentostam, 100 mg/ml) is infiltrated through the surrounding normal skin to the lesion for each 1cm2 area of the lesion, making a wheal and this procedure repeated to cover the whole lesion and the other labelled lesion is infiltrated by 0.2mlof metronidazole solution (Flagyl, 5mg/ml) for each 1cm2area of the lesion and this procedure is repeated until blanching of the whole lesion were occurred. this procedure is done weekly for 4 weeks duration and during each visit the lesions were measured in size and photographed again and documented. Results A significant association was observed between lesions treated with sodium stibogluconate solution and complete improvement (p

Keywords: leishmaniasis

Edition: Volume 7 Issue 5, May 2018,

Pages: 1206 - 1220