Title : Treatment of old world cutaneous leishmaniasis with paromomycin cream, oral dapsone alone and in combination in Algabal Algarby Libya
Background: Cutaneous leishmaniasis (CL) is endemic in many regions of the world, and has a significant economic and health impacts. Despite the numerous proposed therapies for this zoonotic parasitic disease. Currently, there is no definitive cure for CL. Meglumine antimony compounds are regarded as the typical treatment for leishmaniasis. However, they have a rather high incidence of adversative effects, that always, are not successful. Alternatively, Paromomycin and dapsone were used in various studies, though, with conflict results.
Aim of study: This study aims to evaluate the clinical efficacy and safety of using of paromomycin cream, oral dapson and their combination in treatment of CL.
Patients and Methods: This study is a prospective randomized clinical trial was carried out at the private outpatient Al- Ahlam Center of Dermatology and Cosmetology in city of Gharyan, Libya. That started from 1st of January 2020 to end of Dec 2021. 42 patients were joining this study, and randomly were divided into three groups according to protocol of treatment to assess the clinical response of the treatment methods.
Results Regarding the outcome of the three different treatment regimen and after exclusion of the patients stop their follow-up; we found that 50% of dapsone treated group cleared the lesions in 1-2 months versus only 40% in paromomycin & Dapsone treated group and 0% for the paromomycin group, only 8 patients had no improvement with received treatment; 4 (33.3%) from dapsone group, 2 (20%) from each other group (P=0.036)
Conclusion: Using of paromomycin & dapson combination in treatment of cutaneous leishmaniasis shows better result and early clearance LC lesions, whereas, using of topical paromomycin cream or oral dapsone alone were effective. Also, our results showed that, paromomycin is effective, safe and well tolerated in children. Keywords: Cutaneous leishmaniasis, Paromomycin, Dapson, Gharyan, Libya