The adequate treatment of the American tegumentary leishmaniasis is crucial since the disease, differently from the caused by the Old World species, is painful and not self-healing and may lead to the disfiguring mucosal involvement. So far, pentavalent antimony compounds have been considered the treatment of choice for cutaneous leishmaniasis (CL), however, these drugs present high frequency of side effects and important disadvantages as parenteral administration and need for careful renal and cardiac monitoring. Azithromycin is a macrolide antibiotic, non-expensive, largely commercially available that has shown in-vitro and in vivo activity against different species of Leishmania. The main objective of this study is to evaluate the efficacy and safety of oral azithromycin for the treatment of CL. The efficacy of oral treatment of azithromycin 500 mg/day for 20 days is going to be compared with the standard treatment of intramuscular injections of 20 mg/Kg/day of pentavalent antimonials (Glucantime®) for 20 days in patients with CL from two endemic regions of Brazil: the metropolitan region of Belo Horizonte and Montes Claros (MG)in the southeast Brazil and in Corte de Pedras (Bahia), Northeastern Brazil. The patients follow up lasts for 12 months.
Included a new site (University Estadual de Montes Claros - UNIMONTES) in 7 June 2010. The site was included due the need to achieve more patients. The ANVISA (National Agency of Sanitary Surveillance) approved these site in March 2011 and the start of activities is planned for June 2011.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
48
15mg Sb+5/Kg/day, during 20 days. Maximum dose:15ml/day
Zithromax ®/ Pfizer, 500 mg - 1x day, during 20 days
Núcleo de Medicina Tropical University of Brasília - Health Center Corte de Pedras
Presidente Tancredo Neves, Estado de Bahia, Brazil
Centro de Pesquisas René Rachou - Fiocruz
Belo Horizonte, Minas Gerais, Brazil
University Estadual de Montes Claros
Montes Claros, Minas Gerais, Brazil
Proportion of clinically cured patients
A cure was defined as complete lesion healing and re-epithelialization without inflammatory infiltration and erythema until 90 days after the treatment ended.
Time frame: at the third month after treatment
Proportion of patients with failure and cured
Proportion of cured patients at 1, 2, 3, 6, 9 and 12 follow-up after completion of treatment. Mean time to healing.
Time frame: twelve months after treatment
Occurrence of mucosal lesions after treatment
Proportion of patients with relapsed or mucosal lesion in 6 months, 9 and 12 follow-up after completion of treatment.
Time frame: twelve months after treatment
Proportion of patients presenting new lesions
Proportion of patients with new lesions at 1, 2, 3, 6, 9 and 12 follow-up after completion of treatment.
Time frame: 1st 2nd 3rd 6th 12th month after treatment
Proportion of adverse events on each treatment group
Proportion of patients clinical, electrocardiographic and laboratory adverse events.
Time frame: 1st 2nd 3rd 6th 12th month after treatment.
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