Avaliation the Therapeutic Effiacy of Fluconazol
Keywords:Cutaneous Leishmaniasis. Fluconazol. Meglumine.
Leishmaniasis is a group of diseases with a large spectrum, cosmopolitan, but with broad and signifiant impact in the tropical zone. Leishmaniasis presents itself in two forms, one visceral involving hemolinfopoietic system structures, other with skin and/or mucosa involvement,Â often without visceralizing. The latter, known as American CutaneousÂ Leishmaniasis (ACL) is the aim of this study. One of the major problemsÂ in the ACL is treatment procedure using injectable formulations, with
risk for complications from the injection and the risk of damage toÂ the liver and kidney function and cardiac complications. Several testsÂ have demonstrated satisfactory results using FluconazoleÂ®. In order toÂ consolidate the results described in the literature, this study sought toÂ demonstrate the therapeutic effiacy of FluconazoleÂ® with high-doseÂ treatment of ACL in patients from an endemic area in the SouthernÂ State of CearÃ¡, Brazil, City of Barbalha. Itâ€™s conducted a prospectiveÂ randomized study with two groups of patients. Sixty of the GroupÂ I: they were treated with 300mg or 450mg of FluconazoleÂ® for sixÂ weeks. Sixty Group II: they were treated with Glucantime 20mg/kg/Â day for 20 consecutive days. The diagnosis of ACL was performed withÂ Imprint, culture, biopsy and histopathological stain with Giemsa andÂ immunohistochemistry. Montenegroâ€™s Intradermoreaction was alsoÂ performed. All patients were evaluated clinically and followed up forÂ ninety days. Continuous variables were evaluated by Student's t test,Â and for the correlation of variables the Pearson correlation coeffiientÂ (r) was used. The time healing of each group had its evaluation byÂ Kaplan-Meier method. In all tests the hypothesis Î± was consideredÂ signifiant when less than 5% (p <0.05). The therapeutic effiacy (TE)Â was calculated based on the reduction of relative risk. The study population was predominantly made up of individuals between 30 andÂ 40 years, brown skin color, peasants, rural people, with a slight prevalence of females. The results showed therapeutic effiacy of 38.7%. The cure was related to the size of the lesion, relevant factor in the statistical p <0.0001. The lesions smaller than 30 mm (alone or sum of multiple lesions) responded promptly to FluconazoleÂ®
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