Iraji F, Sadeghinia A
Department of Dermatology, Isfahan University of Medical Sciences, Isfahan, Iran.
Ann Trop Med Parasitol. 2005 Jan;99(1):3-9. doi: 10.1179/136485905X16372.
Although pentavalent antimonials are often used in the first-line treatment of cutaneous leishmaniasis (CL), they have several adverse effects. Intralesional administration of antimonials and other antileishmanial drugs can be painful. In the present, double-blind, randomized study, to determine if topical treatment with paromomycin is effective in the treatment of CL, 35 cases of CL were treated, twice daily for 30 days, with a commercial skin-care lotion containing 10% urea (the placebo) and another 30 were similarly treated with the same lotion to which paromomycin sulphate had been added (to give a concentration of 15%). Each case was assessed clinically 7, 14, 21 and 30 days after treatment began, and parasitologically 30 and 60 days after the initiation of treatment. Five (17%) and five (17%) of the cases treated with paromomycin showed complete healing, with the apparent clearance of amastigotes from their lesions, 30 and 60 days after treatment began, respectively. At the same time-points, however, the lesions on six (17%) and seven (20%) of the cases in the placebo group, respectively, also appeared to have healed completely. Ointment containing 15% paromomycin therefore appears ineffective in the treatment of CL, at least when applied twice daily for 30 days to the lesions of cases from an endemic area of Isfahan, Iran.
尽管五价锑化合物常用于皮肤利什曼病（CL）的一线治疗，但它们有多种不良反应。病灶内注射锑化合物和其他抗利什曼药物可能会引起疼痛。在本次双盲随机研究中，为确定局部使用巴龙霉素治疗CL是否有效，35例CL患者接受了每日两次、为期30天的治疗，使用一种含10%尿素的商用护肤品洗剂（安慰剂），另外30例患者则使用添加了硫酸巴龙霉素（浓度为15%）的相同洗剂进行类似治疗。在治疗开始后的第7、14、21和30天对每个病例进行临床评估，并在治疗开始后的第30和60天进行寄生虫学评估。使用巴龙霉素治疗的病例中，分别在治疗开始后的30天和60天，有5例（17%）和5例（17%）显示完全愈合，病灶内无鞭毛体明显清除。然而，在同一时间点，安慰剂组分别有6例（17%）和7例（20%）的病灶似乎也已完全愈合。因此，含15%巴龙霉素的软膏似乎对CL治疗无效，至少在伊朗伊斯法罕流行地区的病例病灶上每日两次、持续30天使用时是这样。
