Self-application of aminoglycoside-based creams to treat cutaneous leishmaniasis in travelers.
Background In endemic foci, the use of an aquaphilic cream containing paromomycin with/without gentamicin to treat cutaneous leishmaniasis (CL) is safe, painless and cures 78-82% of patients with New and Old World CL. Self-application in travelers requires evaluation. Methods Travelers with 1-10 les...
Published in: | PLOS Neglected Tropical Diseases |
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Online Access: | https://doi.org/10.1371/journal.pntd.0011492 https://doaj.org/article/088c64dac03348fc8fad665a2632743c |
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ftdoajarticles:oai:doaj.org/article:088c64dac03348fc8fad665a2632743c 2023-11-05T03:40:06+01:00 Self-application of aminoglycoside-based creams to treat cutaneous leishmaniasis in travelers. Oussama Mouri Cléa Melenotte Romain Guéry Camille Cotteret Arnaud Schweitzer-Chaput Alice Perignon Marc Thellier Emmanuelle Bourrat Florentia Kaguelidou Jean Yves Siriez Denis Malvy Jean-Pierre Gangneux Alexandre Duvignaud Christophe Ravel Salvatore Cisternino Janet Ransom Eric Caumes Olivier Lortholary Max Grogl Pierre Buffet 2023-08-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0011492 https://doaj.org/article/088c64dac03348fc8fad665a2632743c EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0011492 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011492 https://doaj.org/article/088c64dac03348fc8fad665a2632743c PLoS Neglected Tropical Diseases, Vol 17, Iss 8, p e0011492 (2023) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2023 ftdoajarticles https://doi.org/10.1371/journal.pntd.0011492 2023-10-08T00:37:57Z Background In endemic foci, the use of an aquaphilic cream containing paromomycin with/without gentamicin to treat cutaneous leishmaniasis (CL) is safe, painless and cures 78-82% of patients with New and Old World CL. Self-application in travelers requires evaluation. Methods Travelers with 1-10 lesions of confirmed CL were prospectively treated with the paromomycin-gentamicin formulation (WR279396, 2012-2017, Group 1) and carefully follow up, or treated with a locally produced paromomycin-only cream (2018-2022, Group 2). The cream was applied once under supervision, then self-applied daily for 20-30 days. A cured lesion was defined as 100% re-epithelialization at day 42 without relapse at three months. Results Medical features were similar in Group 1 (17 patients), and Group 2 (23 patients). Patients were infected with either Leishmania major, L. infantum, L. killicki, L. guyanensis, L. braziliensis, or L. naiffi. Intention-to-treat and per-protocol cure rates were 82% (95% confidence interval (CI) [64.23;100.00]) and 87% (95% CI [71,29;100.00]) in Group 1, and 69% (95% CI [50.76; 88.37]) and 76% (95% CI [57.97; 94.41]) in Group 2. In the pooled Group 1&2, 75% (95% CI [61.58;88.42]) (30/40) and 81% (95% CI [68,46;93.6]) (30/37) of patients were cured in intention-to-treat and per-protocol, respectively. There were no significant differences observed in the success rates between Old World and New World CL (83.3% vs. 60%, p = 0.14). Prospective observations in Group 1 showed that adverse events were mainly pruritus (24%) and pain (18%) on lesions (all mild or moderate). No mucosal involvement was observed in either group. Discussion In this representative population of travelers who acquired CL either in the Old or New World, the 81% per-protocol cure rate of a self-applied aminoglycoside cream was similar to that observed in clinical trials. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles PLOS Neglected Tropical Diseases 17 8 e0011492 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Oussama Mouri Cléa Melenotte Romain Guéry Camille Cotteret Arnaud Schweitzer-Chaput Alice Perignon Marc Thellier Emmanuelle Bourrat Florentia Kaguelidou Jean Yves Siriez Denis Malvy Jean-Pierre Gangneux Alexandre Duvignaud Christophe Ravel Salvatore Cisternino Janet Ransom Eric Caumes Olivier Lortholary Max Grogl Pierre Buffet Self-application of aminoglycoside-based creams to treat cutaneous leishmaniasis in travelers. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background In endemic foci, the use of an aquaphilic cream containing paromomycin with/without gentamicin to treat cutaneous leishmaniasis (CL) is safe, painless and cures 78-82% of patients with New and Old World CL. Self-application in travelers requires evaluation. Methods Travelers with 1-10 lesions of confirmed CL were prospectively treated with the paromomycin-gentamicin formulation (WR279396, 2012-2017, Group 1) and carefully follow up, or treated with a locally produced paromomycin-only cream (2018-2022, Group 2). The cream was applied once under supervision, then self-applied daily for 20-30 days. A cured lesion was defined as 100% re-epithelialization at day 42 without relapse at three months. Results Medical features were similar in Group 1 (17 patients), and Group 2 (23 patients). Patients were infected with either Leishmania major, L. infantum, L. killicki, L. guyanensis, L. braziliensis, or L. naiffi. Intention-to-treat and per-protocol cure rates were 82% (95% confidence interval (CI) [64.23;100.00]) and 87% (95% CI [71,29;100.00]) in Group 1, and 69% (95% CI [50.76; 88.37]) and 76% (95% CI [57.97; 94.41]) in Group 2. In the pooled Group 1&2, 75% (95% CI [61.58;88.42]) (30/40) and 81% (95% CI [68,46;93.6]) (30/37) of patients were cured in intention-to-treat and per-protocol, respectively. There were no significant differences observed in the success rates between Old World and New World CL (83.3% vs. 60%, p = 0.14). Prospective observations in Group 1 showed that adverse events were mainly pruritus (24%) and pain (18%) on lesions (all mild or moderate). No mucosal involvement was observed in either group. Discussion In this representative population of travelers who acquired CL either in the Old or New World, the 81% per-protocol cure rate of a self-applied aminoglycoside cream was similar to that observed in clinical trials. |
format |
Article in Journal/Newspaper |
author |
Oussama Mouri Cléa Melenotte Romain Guéry Camille Cotteret Arnaud Schweitzer-Chaput Alice Perignon Marc Thellier Emmanuelle Bourrat Florentia Kaguelidou Jean Yves Siriez Denis Malvy Jean-Pierre Gangneux Alexandre Duvignaud Christophe Ravel Salvatore Cisternino Janet Ransom Eric Caumes Olivier Lortholary Max Grogl Pierre Buffet |
author_facet |
Oussama Mouri Cléa Melenotte Romain Guéry Camille Cotteret Arnaud Schweitzer-Chaput Alice Perignon Marc Thellier Emmanuelle Bourrat Florentia Kaguelidou Jean Yves Siriez Denis Malvy Jean-Pierre Gangneux Alexandre Duvignaud Christophe Ravel Salvatore Cisternino Janet Ransom Eric Caumes Olivier Lortholary Max Grogl Pierre Buffet |
author_sort |
Oussama Mouri |
title |
Self-application of aminoglycoside-based creams to treat cutaneous leishmaniasis in travelers. |
title_short |
Self-application of aminoglycoside-based creams to treat cutaneous leishmaniasis in travelers. |
title_full |
Self-application of aminoglycoside-based creams to treat cutaneous leishmaniasis in travelers. |
title_fullStr |
Self-application of aminoglycoside-based creams to treat cutaneous leishmaniasis in travelers. |
title_full_unstemmed |
Self-application of aminoglycoside-based creams to treat cutaneous leishmaniasis in travelers. |
title_sort |
self-application of aminoglycoside-based creams to treat cutaneous leishmaniasis in travelers. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2023 |
url |
https://doi.org/10.1371/journal.pntd.0011492 https://doaj.org/article/088c64dac03348fc8fad665a2632743c |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 17, Iss 8, p e0011492 (2023) |
op_relation |
https://doi.org/10.1371/journal.pntd.0011492 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011492 https://doaj.org/article/088c64dac03348fc8fad665a2632743c |
op_doi |
https://doi.org/10.1371/journal.pntd.0011492 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
17 |
container_issue |
8 |
container_start_page |
e0011492 |
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1781696058956447744 |