Effect of intralesional levofloxacin in the treatment of cutaneous leishmaniasis intralesional levofloxacin for cutaneous leishmaniasis treatment
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Keywords
Cutaneous leishmaniosis' Intralesional' Levofloxacin.
Abstract
Background: Several areas throughout the world are more susceptible to having cutaneous leishmaniasis (CL), yet the illness is present all over the world. Skin ulcers are the hallmark of CL, most likely caused by the immune system's attempts to suppress the proliferation of Leishmania parasites.
Objectives: To investigate the effectiveness of intralesional levofloxacin in localized cutaneous leishmaniasis treatment.
Methods: A cohort study was carried on from November 2021 to March 2022 at dermatologist clinic in Badrah district of Wasit province, in the east of Iraq. 50 male and female patients with age ranged from 8-34 (median ±SD; 20±6.58) with localized cutaneous leishmaniasis were enrolled in the study. The diagnosis of localized cutaneous leishmaniasis was done at the clinic. An average dose of 1 mL of Levofloxacin solution for every 1 cm diameter were given subcutaneously to all patients every five days for 3-5 times during the treatment period (median ±SD; 4±0.74).
Results: It was demonstrated that 45 patients out of 50 who received the intralesional levofloxacin showed a response toward treatment and cured completely with a (cure rate of 90%). The diameters of lesion were decreased significantly (p<0.001) from (median ±SD; 20±4.93) to (median ±SD; 15±3.71 mm) that healed completely after (median ±SD; 23±3.99 day). The reduction in the lesion diameter accompanied with a disappearance of ulceration, pain and tenderness at the lesion site which is achieved after complete healing that obtained within one month of treatment. It was observed that the dimeter of lesion before and after treatment were significantly and positively correlated with each other and also positively and significantly correlated with the age, healing time and the number of visits.
Conclusion: Intralesional levofloxacin may have an important role in the treatment of localized cutaneous leishmaniasis as it showed a high effectiveness against the cutaneous lesions due to its antiparasitic activity.
References
2. Murray HW, Berman JD, Davies CR, Saravia NG. Advances in leishmaniasis. Lancet. 2005;366(9496):1561-77. doi: 10.1016/S0140-6736(05)67629-5
3. Reithinger R, Dujardin JC, Louzir H, Pirmez C, Alexander B, Brooker S. Cutaneous leishmaniasis. Lancet Infect Dis. 2007;7(9):581-96. doi: 10.1016/S1473-3099(07)70209-8.
4. Rani R, Mishra S. Synthesis of Diaryl Heptanoid Based Ketene Dithioacetals as Novel Antileishmanial Agents. Asian J. Research Chem. 2011;4(7):1188-1193.
5. Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, den Boer M; WHO Leishmaniasis Control Team. Leishmaniasis worldwide and global estimates of its incidence. PLoS One. 2012;7(5):e35671. doi: 10.1371/journal.pone.0035671.
6. Dwivedi PK, Tripathi K, Mishra M, Ray S. Antileishmanial Agents: A Review. Research J. Pharmacognosy and Phytochemistry 2010; 2(4): 264-266.
7. Vera-Izaguirre DS, Vega-Memije E, Quintanilla-Cedillo MR, Arenas R. Leishmaniasis. Revisión. Dermatología Cosmética, Médica y Quirúrgica. 2006;4(4):252-260.
8. Tripathi A, Vyas A. In-vitro evaluation of nano-liposomal formulation of Fluconazole and Amphotericin B against visceral leishmaniasis. Research Journal of Pharmacy and Technology. 2021; 14(9):4929-3. doi: 10.52711/0974-360X.2021.00857
9. Machado PR, Lessa H, Lessa M, Guimarães LH, Bang H, Ho JL, Carvalho EM. Oral pentoxifylline combined with pentavalent antimony: a randomized trial for mucosal leishmaniasis. Clin Infect Dis. 2007;44(6):788-93. doi: 10.1086/511643. Epub 2007 Feb 2.
10. Dalhoff A. Antiviral, antifungal, and antiparasitic activities of fluoroquinolones optimized for treatment of bacterial infections: a puzzling paradox or a logical consequence of their mode of action?. Eur J Clin Microbiol Infect Dis. 2015;34(4):661-668. doi: 10.1007/s10096-014-2296-3
11. Devi SC, Saravanan H, Joseph RE, Koturan S, Srinivasan MV. Leishmaniasis: A Review on Global Epidemiological Trends. Research J. Pharm. and Tech. 2014;7(5):569-574.
12. Norman G. Likert scales, levels of measurement and the "laws" of statistics. Adv Health Sci Educ Theory Pract. 2010;15:625-32.
13. 11b. Croom KF, Goa KL. Levofloxacin: a review of its use in the treatment of bacterial infections in the United States. Drugs. 2003;63(24):2769-802. doi: 10.2165/00003495-200363240-00008. PMID: 14664657.
14. Bush NG, Diez-Santos I, Abbott LR, Maxwell A. Quinolones: Mechanism, Lethality and Their Contributions to Antibiotic Resistance. Molecules. 2020;25(23):5662. doi: 10.3390/molecules25235662.
15. Shahnaz HM, Arayne S, Sultana N, Haider A. In vitro drug interaction studies of Fexofenadine with Enoxacin, Levofloxacin and Sparfloxacin. Asian J. Research Chem. 2012;5(5):687-696.
16. Sebaiy MM, El-Shanawany AA, El-Adl SM, Abdel-Aziz LM, Hashem HA. Rapid RP-HPLC Method for Simultaneous Estimation of Levofloxacin Hydrochloride, Lomefloxacin Hydrochloride, Gatifloxacin and Sparfloxacin. Asian J. Research Chem. 2011;4(11):1688-1694.
17. Dar MA, Sharma A, Mondal N, Dhar SK. Molecular cloning of apicoplast-targeted Plasmodium falciparum DNA gyrase genes: unique intrinsic ATPase activity and ATP-independent dimerization of PfGyrB subunit. Eukaryot Cell. 2007;6(3):398-412. doi: 10.1128/EC.00357-06
18. Patel PR, Patel VB, Bapna M. Simultaneous Determination of Levofloxacin and Ornidazole by Ratiospectra Derivative Spectrophotometry and High Performance Liquid Chromatography. Asian J. Research Chem. 2010;3(4):922-927.
19. Bankhele SC, Harale RB, Rao MRP, Dhoka MV. Thermoreversible In-Situ Ophthalmic Gelling System of Levofloxacin Hemihydrate: Formulation and Optimization by Factorial Design. Asian J. Pharm. Res. 2012;2(3):100-106.
20. Piscopo TV, Mallia Azzopardi C. Leishmaniasis. Postgrad Med J. 2007 Feb;83(976):649-57. doi: 10.1136/pgmj.2006.047340corr1. PMID: 17396274; PMCID: PMC3202701.
21. Oliveira F, Bafica A, Rosato AB, Favali CB, Costa JM, Cafe V, Barral-Netto M, Barral A. Lesion size correlates with Leishmania antigen-stimulated TNF-levels in human cutaneous leishmaniasis. Am J Trop Med Hyg. 2011 Jul;85(1):70-3. doi: 10.4269/ajtmh.2011.10-0680. PMID: 21734128; PMCID: PMC3122347.
22. Sharifi I, Aflatoonian MR, Fekri AR, Hakimi Parizi M, Aghaei Afshar A, Khosravi A, Sharifi F, Aflatoonian B, Khamesipour A, Dowlati Y, Modabber F, Nadim A. A comprehensive review of cutaneous leishmaniasis in kerman province, southeastern iran-narrative review article. Iran J Public Health. 2015;44(3):299-307.
23. Flora AM, S, Namasivayam SKR, Nandhini S, Cinthya S, Grishma G. Polymer Coated Ovalbumin Nanoparticles loaded Levofloxacin Preparation for the Improved Antibacterial Activity. Research J. Pharm. and Tech.2016; 9(4): 419-422. doi: 10.5958/0974-360X.2016.00077.9
24. Swapna G, Pravallika B, Poojitha J. A Review on Drug-drug interaction studies on Amiodarone and Levofloxacin. Res. J. Pharmacology & Pharmacodynamics.2019; 11(4):147-152. doi: 10.5958/2321-5836.2019.00026.0
25. Valencia C, Arévalo J, Dujardin JC, Llanos-Cuentas A, Chappuis F, Zimic M. Prediction score for antimony treatment failure in patients with ulcerative leishmaniasis lesions. PLoS Negl Trop Dis. 2012;6(6):e1656. doi: 10.1371/journal.pntd.0001656
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Dr. Ahmed Hamza Al-Shammari , Department of Pharmacy, Kut University College, Alkut, Wasit, Iraq
Ass. Lec. Abdullah Q. Khudhur , Department of Pharmacy, Baghdad College of Medical Sciences, Baghdad, Iraq,
Dr. Haidar A Abdulamir, Department of Dentistry, Hilla university college, Babylon, Iraq