Metronidazole versus Pentostam for treatment of cutaneous leishmaniasis

BACKGROUND: The cutaneous leishmaniasis of old world is a skin distorting disease and considered as a social stigma in countries of the Asia, Mediterranean and Middle East including Iraq. Many drugs nowadays have been reported to have a clinical efficacy against cutaneous leishmaniasis but only a few have been proven worthy. In this study, we aim to compare the efficacy and safety of Intralesional sodium stibogluconate (Pentostam (R) 100 mg/mL) and Intralesional metronidazole (flagyl (R) 5 mg/mL) solutions in the treatment of cutaneous leishmaniasis. METHODS: A clinical trial was done in Dermatology Consultancy Clinic of Al-Hussain Teaching Hospital, Nassiriah (Thi Qar Province Center), Iraq, during the period from June 2015 to June 2016 on a convenient sample of 100 patients with cutaneous leishmaniasis. Those patients were assigned randomly into two groups according to type of localized treatment (50 patients on Pentostam) and (50 patients on Metronidazole) and seen weekly for a maximum of 8 weeks. RESULTS: Patients treated with Pentostam were significantly associated with a higher complete response rate than patients treated with Metronidazole (P<0.001). Complications of treatment were significantly detected among patients treated with Pentostam (P<0.001). Pain at injection site was significantly perceived as severe among patients treated with Pentostam (P<0.001). CONCLUSIONS: Pentostam solution has a higher efficacy in the treatment of cutaneous leishmaniasis than Metronidazole solution but with higher rates of complications and pain at injection site.