Table of Contents
ISRN Parasitology
Volume 2014 (2014), Article ID 548010, 4 pages
http://dx.doi.org/10.1155/2014/548010
Research Article

Efficacy and Safety of Paromomycin in Treatment of Post-Kala-Azar Dermal Leishmaniasis

Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India

Received 10 November 2013; Accepted 29 January 2014; Published 6 March 2014

Academic Editors: J. Berman, M. Jiménez, and O. F. Osman

Copyright © 2014 Shyam Sundar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Post-kala-azar dermal leishmaniasis (PKDL) plays an important role in maintaining endemicity of visceral leishmaniasis and its transmission. Treatment regimens for PKDL are toxic and require 3-4 months of hospitalization. These long and arduous regimens result in extensive noncompliance. There is an urgent need to develop a safe, effective, and acceptable regimen for the treatment of PKDL. Paromomycin (PM) has been recently approved in India for treatment of visceral leishmaniasis (VL); hence we tested its efficacy in patients with PKDL. Methods. In this exploratory study, 31 patients with PKDL aged 10 years and above were administered PM 11 mg/kg daily intramuscularly for 45  days and followed up for one year. Results. Out of 31 patients, 7 patients were lost to followup at 1  year and 9 (37.5%) got cured with complete disappearance of lesion, while 15 (62.5%) showed no improvement by per protocol analysis. Conclusion. Cure rate with 45 intramuscular injections of PM was unacceptably low though there was no serious side effect of the drug. Whether paromomycin can be used in multidrug therapy to shorten the duration of treatment should be the next logical step for investigation.