Soto J, Buffet P, Grogl M, Berman J
Bogota Military Hospital, Colombia.
Am J Trop Med Hyg. 1994 Jan;50(1):107-11. doi: 10.4269/ajtmh.1994.50.107.
We previously found that 2 mg of pentamidine isethionate/kg, administered every other day in seven injections, was 95% curative for Colombian cutaneous leishmaniasis. However, 17% of the patients had to prematurely terminate therapy due to drug toxicity and another 30% had mild-to-moderate toxic clinical reactions. In this report, we show that the same daily dose of drug, 2 mg/kg, but administered in only four every-other-day injections, resulted in an 84% cure rate in 38 patients. Twenty-one patients (55%) experienced side effects, three of which were moderate to severe. A higher daily dose of drug, 3 mg/kg, administered in four every-other-day injections, resulted in a 96% cure rate in 51 evaluable patients. Thirty-six of the treated patients (64%) experienced side effects, five of which were moderate to severe. Although hypotension and hypoglycemia were looked for in all patients, only one patient experienced hypoglycemia and it had normalized by follow-up. We propose that the regimen of 3 mg of pentamidine/kg every other day in four injections is optimal for Colombian cutaneous leishmaniasis and competitive with standard Glucantime therapy, in terms of cure rate, toxicity, length of time the patient has to be under medical supervision, and cost of drug plus medical attention. We suggest that such a short course of injectable agent be studied for the treatment of patients with cutaneous leishmaniasis from other endemic areas.
我们之前发现，每两天注射一次，每次2毫克/千克的乙磺半胱氨酸喷他脒，共注射七次，对哥伦比亚皮肤利什曼病的治愈率为95%。然而，17%的患者因药物毒性不得不提前终止治疗，另有30%的患者出现轻度至中度的毒性临床反应。在本报告中，我们表明，相同的每日剂量药物，2毫克/千克，但仅每两天注射四次，38名患者的治愈率为84%。21名患者（55%）出现副作用，其中3例为中度至重度。更高的每日剂量药物，3毫克/千克，每两天注射四次，51名可评估患者的治愈率为96%。36名接受治疗的患者（64%）出现副作用，其中5例为中度至重度。尽管对所有患者都进行了低血压和低血糖的检查，但只有一名患者出现低血糖，且在随访时已恢复正常。我们认为，每两天注射一次，每次3毫克/千克喷他脒，共注射四次的方案对哥伦比亚皮肤利什曼病是最佳的，在治愈率、毒性、患者需要接受医学监督的时间长度以及药物加医疗护理成本方面，与标准的葡糖胺锑钠治疗具有竞争力。我们建议对这种短疗程注射剂治疗其他流行地区皮肤利什曼病患者进行研究。
