Sadeghian G, Ziaei H, Bidabadi L Shirani, Baghbaderani A Zolfaghari
Skin Disease and Leishmaniasis Research Center, Isfahan, Iran.
Indian J Dermatol. 2011 Jan;56(1):37-9. doi: 10.4103/0019-5154.77549.
Glucantime is regarded as the first-line treatment of cutaneous leishmaniasis (CL); however, failure to treatment is a problem in many cases.
The aim was to evaluate the therapeutic effect of glucantime in CL complicated with secondary bacterial infection compared to uncomplicated lesions.
This experimental study was performed in Skin Diseases and Leishmaniasis Research Center, Isfahan, Iran. A total of 161 patients enrolled in the study had CL confirmed by positive smear of lesions. All the patients were treated with systemic glucantime for 3 weeks and followed for 2 months. Response to treatment was defined as loss of infiltration, reepithelization, and negative smear. Depending on the results of bacterial cultures, the lesions were divided into two groups and the efficacy of glucantime was compared.
A total of 123 patients (76.4%) were negative, and 38 patients (23.6%) were positive for secondary bacterial infection. In groups with negative bacterial culture response to treatment was 65% (80 patients) and in the other positive group, it was 31.6% (12 patients), with a difference (χ(2) = 13.77, P < 0.01).
Therapeutic effect of glucantime showed a decrease in CL lesions with secondary bacterial infection. Therefore, in the cases of unresponsiveness to treatment, the lesions should be evaluated for bacterial infection, before repeating the treatment.
葡糖胺被视为皮肤利什曼病（CL）的一线治疗药物；然而，在许多病例中治疗失败是一个问题。
目的是评估葡糖胺在合并继发性细菌感染的CL患者中与未合并感染的皮损相比的治疗效果。
本实验研究在伊朗伊斯法罕的皮肤病和利什曼病研究中心进行。共有161名经皮损涂片阳性确诊为CL的患者纳入研究。所有患者接受全身葡糖胺治疗3周，并随访2个月。治疗反应定义为浸润消失、上皮再生和涂片阴性。根据细菌培养结果，将皮损分为两组并比较葡糖胺的疗效。
共有123名患者（76.4%）细菌培养结果为阴性，38名患者（23.6%）继发性细菌感染阳性。细菌培养阴性组的治疗反应率为65%（80例患者），另一阳性组为31.6%（12例患者），差异有统计学意义（χ(2)=13.77，P<0.01）。
葡糖胺对合并继发性细菌感染的CL皮损的治疗效果降低。因此，在治疗无反应的病例中，在重复治疗前应评估皮损是否存在细菌感染。
