Review of Leishmaniasis Treatment: Can We See the Forest through the Trees?
There are three known clinical syndromes of leishmaniasis: cutaneous (CL), mucocutaneous (MCL), and visceral disease (VL). In MCL and VL, treatment must be systemic (either oral or intravenous), while CL treatment options vary and include observation-only localized/topical treatment, oral medication...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Pharmacy |
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| Online Access: | https://www.mdpi.com/2226-4787/12/1/30 |
| _version_ | 1797297224239022080 |
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| author | Moshe Shmueli Shalom Ben-Shimol |
| author_facet | Moshe Shmueli Shalom Ben-Shimol |
| author_sort | Moshe Shmueli |
| collection | DOAJ |
| description | There are three known clinical syndromes of leishmaniasis: cutaneous (CL), mucocutaneous (MCL), and visceral disease (VL). In MCL and VL, treatment must be systemic (either oral or intravenous), while CL treatment options vary and include observation-only localized/topical treatment, oral medications, or parenteral drugs. Leishmaniasis treatment is difficult, with several factors to be considered. First, the efficacy of treatments varies among different species of parasites prevalent in different areas on the globe, with each species having a unique clinical presentation and resistance profile. Furthermore, leishmaniasis is a neglected tropical disease (NTD), resulting in a lack of evidence-based knowledge regarding treatment. Therefore, physicians often rely on case reports or case series studies, in the absence of randomized controlled trials (RCT), to assess treatment efficacy. Second, defining cure, especially in CL and MCL, may be difficult, as death of the parasite can be achieved in most cases, while the aesthetic result (e.g., scars) is hard to predict. This is a result of the biological nature of the disease, often diagnosed late in the course of disease (with possible keloid formation, etc.). Third, physicians must consider treatment ease of use and the safety profile of possible treatments. Thus, topical or oral treatments (for CL) are desirable and promote adherence. Fourth, the cost of the treatment is an important consideration. In this review, we aim to describe the diverse treatment options for different clinical manifestations of leishmaniasis. For each currently available treatment, we will discuss the various considerations mentioned above (efficacy, ease of use, safety, and cost). |
| first_indexed | 2024-03-07T22:17:17Z |
| format | Article |
| id | doaj.art-b5eeafe38f8940918a3e1d107c23433c |
| institution | Directory Open Access Journal |
| issn | 2226-4787 |
| language | English |
| last_indexed | 2024-03-07T22:17:17Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmacy |
| spelling | doaj.art-b5eeafe38f8940918a3e1d107c23433c2024-02-23T15:31:25ZengMDPI AGPharmacy2226-47872024-02-011213010.3390/pharmacy12010030Review of Leishmaniasis Treatment: Can We See the Forest through the Trees?Moshe Shmueli0Shalom Ben-Shimol1Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, IsraelFaculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, IsraelThere are three known clinical syndromes of leishmaniasis: cutaneous (CL), mucocutaneous (MCL), and visceral disease (VL). In MCL and VL, treatment must be systemic (either oral or intravenous), while CL treatment options vary and include observation-only localized/topical treatment, oral medications, or parenteral drugs. Leishmaniasis treatment is difficult, with several factors to be considered. First, the efficacy of treatments varies among different species of parasites prevalent in different areas on the globe, with each species having a unique clinical presentation and resistance profile. Furthermore, leishmaniasis is a neglected tropical disease (NTD), resulting in a lack of evidence-based knowledge regarding treatment. Therefore, physicians often rely on case reports or case series studies, in the absence of randomized controlled trials (RCT), to assess treatment efficacy. Second, defining cure, especially in CL and MCL, may be difficult, as death of the parasite can be achieved in most cases, while the aesthetic result (e.g., scars) is hard to predict. This is a result of the biological nature of the disease, often diagnosed late in the course of disease (with possible keloid formation, etc.). Third, physicians must consider treatment ease of use and the safety profile of possible treatments. Thus, topical or oral treatments (for CL) are desirable and promote adherence. Fourth, the cost of the treatment is an important consideration. In this review, we aim to describe the diverse treatment options for different clinical manifestations of leishmaniasis. For each currently available treatment, we will discuss the various considerations mentioned above (efficacy, ease of use, safety, and cost).https://www.mdpi.com/2226-4787/12/1/30cutaneous leishmaniasismucocutaneous leishmaniasisvisceral leishmaniasisadverse eventstreatment |
| spellingShingle | Moshe Shmueli Shalom Ben-Shimol Review of Leishmaniasis Treatment: Can We See the Forest through the Trees? Pharmacy cutaneous leishmaniasis mucocutaneous leishmaniasis visceral leishmaniasis adverse events treatment |
| title | Review of Leishmaniasis Treatment: Can We See the Forest through the Trees? |
| title_full | Review of Leishmaniasis Treatment: Can We See the Forest through the Trees? |
| title_fullStr | Review of Leishmaniasis Treatment: Can We See the Forest through the Trees? |
| title_full_unstemmed | Review of Leishmaniasis Treatment: Can We See the Forest through the Trees? |
| title_short | Review of Leishmaniasis Treatment: Can We See the Forest through the Trees? |
| title_sort | review of leishmaniasis treatment can we see the forest through the trees |
| topic | cutaneous leishmaniasis mucocutaneous leishmaniasis visceral leishmaniasis adverse events treatment |
| url | https://www.mdpi.com/2226-4787/12/1/30 |
| work_keys_str_mv | AT mosheshmueli reviewofleishmaniasistreatmentcanweseetheforestthroughthetrees AT shalombenshimol reviewofleishmaniasistreatmentcanweseetheforestthroughthetrees |