Browsing by Autor "Margarita Balderrama"

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    Efficacy of Miltefosine for Bolivian Cutaneous Leishmaniasis
    (American Society of Tropical Medicine and Hygiene, 2008) Jaime Soto; Jaime Rea; Margarita Balderrama; Julia Toledo; Paula Soto; L Valda; Jonathan Berman
    Oral miltefosine (2.5 mg/kg/d for 28 days) was compared with intramuscular antimony (20 mg/kg/d for 20 days) in the treatment of cutaneous leishmaniasis caused by Leishmania braziliensis in Palos Blancos, Bolivia. The cure rates with 6 months of follow-up were statistically similar: 36 of 41 evaluable miltefosine patients (88%) versus 15 of 16 (94%) evaluable antimony patients. However, antimony cured more rapidly, because, by 1 month after therapy, 31 of 44 miltefosine patients (70%) compared with 16 of 16 antimony patients (100%) had achieved cure. The two conclusions from this work are that oral miltefosine can be used for cutaneous disease in this part of Bolivia and that miltefosine was more effective for L. braziliensis in this region than for L. braziliensis in Guatemala. Chemotherapy needs to be evaluated in each endemic region, even if the "same" species of Leishmania causes disease in these locales.
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    Treatment of Bolivian Mucosal Leishmaniasis with Miltefosine
    (Oxford University Press, 2007) Jaime Soto; Julia Toledo; L Valda; Margarita Balderrama; Irene Maeve Rea; Rolando Sergio Llópiz Parra; J Herrera Ardiles; Paula Soto; Ángel Herrera‐Gómez; F. Molleda
    In this unrandomized trial, oral miltefosine was at least as effective as heroic doses of parenteral amphotericin B. The cure rate for miltefosine was approximately equivalent to historical cure rates using parenteral pentavalent antimony for mild and extensive disease in neighboring Peru. Although gastrointestinal side reactions do occur with miltefosine, its toxicity profile is superior to that of antimony and far superior to that of amphotericin B--in part because of the inherent attractiveness of oral versus parenteral agents. Our results suggest that miltefosine should be the treatment of choice for mucosal disease in North and South America.