Intralesional Metronidazole (5%) VS Intralesional Meglumine Antimonate in Cutaneous Leishmaniasis

Abstract

Background: Leishmaniasis is a vector-borne disease that causes skin infections around the world through the bite of sand fly. This leads to the formation of cutaneous leishmaniasis and scars on the area that a cosmetically significant. Objective: Our study aimed to evaluate the efficacy of intralesional metronidazole (5%) in comparison with intralesionalmeglumineantimonate in the treatment of cutaneous leishmaniasis. Methods: In the current study 40 patients with cutaneous leishmaniasis having upto 3 lesions on either upper limb, lower limb or trunk with a maximum diameter of 3cm in the longest dimension were included in the study and were randomly allocated to either group A (intralesional meglumineantimonate) or group B (intralesional metronidazole). Both treatments were given as intralesional injections on weekly basis, for 12 weeks. Patients were assessed and clinical photographs of the site of treatment were taken on every visit. The response was recorded according to the reduction in the size of the lesion, flattening of the lesion, change in colour, re-epithelialization and disappearance of signs of inflammation. More than 80% improvement to complete resolution of the lesion was considered as a cure. Results: At the end of 12 weeks of treatment 18 out of 20 (90%) patients in treatment group A (intralesional meglumine antimonite) were cured (mean 1.10, SD 0.308), while15 out of 20 (75%) patients responded to the treatment with intralesional metronidazole (mean 1.25, SD 0.444). Although, group A patients had a better cure rate than group B patients but the response to both treatments was found statistically significant and the p-value was 0.0001. Conclusion: This study denoted that cutaneous leishmaniasis best responds to intralesional meglumineantimonate butintralesional metronidazole is found to be a safe and effective alternative treatment for this chronic ailment.