Treatment of Cutaneous Leishmaniasis with Liposomal Amphotericin B in the Elderly: A Randomized Clinical Trial

The efficacy, best dosage, and safety of liposomal amphotericin B (LAB) in the treatment of cutaneous leishmaniasis (CL) caused by Leishmania braziliensis in elderly patients was determined by a randomized, controlled trial. We selected 28 patients of both sexes age 60 years old or older with CL diagnosis confirmed by detection of L. braziliensis DNA. The groups were treated with different total doses of LAB (group 1: 12 mg/kg; group 2: 18 mg/kg; and group 3: 24 mg/kg). Clinical and laboratory evaluations were carried out during a period of 180 days (day 0, day 15, day 30, day 60, day 90, and day 180). The highest cure rate (89%) was in group 3 (differences were not statistically significant) along with the lowest incidence of side effects (11%), suggesting that 24 mg/kg is the best dose of LAB to treat CL in elderly patients.