A randomized, double-blind, clinical trial of topical clotrimazole versus miconazole for treatment of cutaneous leishmaniasis in the eastern province of Saudi Arabia

The parenteral treatment currently available for cutaneous leishmaniasis (CL) is painful and potentially exposes patients to serious side effects. Thus, effective, topical therapy would be valuable. We assessed the efficacy of topical 1% clotrimazole and 2% miconazole creams in relation to early hea...

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Published inThe American journal of tropical medicine and hygiene Vol. 52; no. 2; p. 166
Main Authors Larbi, E B, al-Khawajah, A, al-Gindan, Y, Jain, S, Abahusain, A, al-Zayer, A
Format Journal Article
LanguageEnglish
Published United States 01.02.1995
Subjects
Administration, Topical
Adolescent
Adult
Child
Child, Preschool
Clotrimazole - administration & dosage
Clotrimazole - therapeutic use
Double-Blind Method
Female
Follow-Up Studies
Humans
Infant
Leishmaniasis, Cutaneous - drug therapy
Male
Miconazole - administration & dosage
Miconazole - therapeutic use
Middle Aged
Patient Compliance
Saudi Arabia
Self Administration
Treatment Outcome
Saudi Arabia
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Summary:The parenteral treatment currently available for cutaneous leishmaniasis (CL) is painful and potentially exposes patients to serious side effects. Thus, effective, topical therapy would be valuable. We assessed the efficacy of topical 1% clotrimazole and 2% miconazole creams in relation to early healing of lesions in CL in a randomized, double-blind clinical trial in 54 patients with 151 lesions treated for 30 consecutive days. Response to treatment was assessed at two weeks and 30 days and classified as fully healed, size reduced, no change, and size increased or worse. Of 89 lesions treated with clotrimazole, 14 (15.7%) healed fully, 42 (47.2%) were reduced in size, 20 (22.5%) showed no change, and 13 (14.6%) got worse. Correspondingly, in the 62 lesions treated with miconazole, none healed fully, 22 (35.5%) were reduced in size, 16 (25.8%) showed no change, and 24 (38.7%) got worse. The differences were statistically significant (P < 0.001). No side effects were observed. It is concluded that clotrimazole was the more effective of the two imidazoline compounds and is recommended as initial treatment for simple lesions.
ISSN:0002-9637
DOI:10.4269/ajtmh.1995.52.166