24
Treatment
Intralesional
alternatives
Pentavalent antimonials
4
Sodium stibogluconate (Pentostam
®
)
GlaxoSmithKline
• via CDC Drug Service or
USAMMDA for military health
care beneficiaries
13
• Various regimens: 0.2–5 mL
IL per session every 3–7
days (or up to every 3
weeks) ± cryotherapy
for 5–8 sessions or until
healing.
• 5 sites/lesions with a 25–
27G needle intradermally
for 0.1 mL/cm
2
until
blanched.
Meglumine antimoniate
(Glucantime
®
)
Sanofi
• via Special Access Program in
Canada
As per Pentostam
®
Topical
alternatives
Paromomycin preparations
15% paromomycin and 12% MBCL
ointment (Leshcutan
®
)
• Approximate with compounding
pharmacy
Apply topically bid for 10
days, rest for 10 days, and
reapply bid for 10 days
15% paromomycin and 0.5%
gentamicin cream WR 279,396
Expanded-access IND protocol;
otherwise, approximate with
compounding pharmacy
Apply topically once per day
for 20 days
Heat therapy (ermoMed
™
) TTI
ermosurgery Technologies, Inc.
Apply locally to skin under
local anesthesia for 30-sec
doses in grid-like pattern
extending 1–2 mm into
surrounding normal-
appearing skin. Usually one
session (sometimes up to 3).
Cryotherapy with liquid nitrogen.
No special applicator required.
Multiple regimens: eg, freeze
15–20 sec until 1–2 mm of
normal circumferential skin
frozen, thaw 20–60 sec, and
freeze again. Repeat every
3 weeks for up to 3 total
applications (fewer, if healed
sooner).
Table 3a. Approach to Syndromic Treatment of Cutaneous
Leishmaniasis (CL) in North America
1,2
(cont'd)
Treatment
Classification
Generic (Brand)
Source and Availability Regimen
