COMPARISON OF THE EFFICACY OF INTRALESIONAL INJECTIONS OF MEGLUMINE ANTIMONIATE VERSUS METRONIDAZOLE IN PATIENTS PRESENTING WITH CUTANEOUS LEISHMANIASIS AT TERTIARY CARE HOSPITAL, KARACHI

Abstract

Introduction: Cutaneous leishmaniasis (CL) is one of the common parasite disease that affects people. Sand fly bites are the primary mode of transmission for leishmaniasis, which is often identified by a microscope-assisted smear examination of the afflicted region. Pentavalent antimony compounds like sodium stibogluconate and meglumine antimoniate are the preferred therapies for leishmaniasis. Ongoing research is being done to find effective, less hazardous therapies for leishmaniasis, however alternative drugs have been suggested for the disease.

Objective: To compare the efficacy of “intralesional meglumine antimoniate (MA) versus metronidazole” in patients presenting with CL.

Study Design: “Randomized control trial”.

Subjects and methods: All the 60 patients presenting with Cutaneous Leishmaniasis (CL) at the Outpatient Department of Dermatology, JPMC, Karachi during 29-04-21 till 29-10-21 meeting the selection criteria were enrolled. Disease history, demographic information and written informed consent was obtained from study participants. Patients were divided into two groups at random; (A) Intralesional injections of meglumine antimoniate group and (B) Intralesional injections of metronidazole. The procedure was done weekly for a maximum of 8 weeks’ duration and during each visit the lesions was measured in size and photographed again and documented. Efficacy was labeled if patients with Cutaneous Leishmaniasis lesion in either group showed complete response. All the data collected and entered in the pre-designed Performa.

Results: Mean age and duration of CL in the meglumine antimoniate group was 48.21±6.24 years and 1.54±0.78 weeks. Mean age and duration of cutaneous leishmaniasis in the metronidazole group was 49.48±8.41 years and 1.97±0.56 weeks. Efficacy in meglumine antimoniate and metronidazole group was 24 (80%) and 12 (36.7%) respectively.

Conclusion: Meglumine antimoniate injections intralesionally have demonstrated an improved degree of cure in terms of the lesions' decreased size and induration. Treatment for cutaneous leishmaniasis with this approach is painless, simple to use, effective, and has few adverse effects.