Risk factors for therapeutic failure to meglumine antimoniate and miltefosine in adults and children with cutaneous leishmaniasis in Colombia: A cohort study

Risk factors for therapeutic failure to meglumine antimoniate and miltefosine in adults and children with cutaneous leishmaniasis in Colombia: A cohort study
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DOI:
10.1371/journal.pntd.0005515
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发表时间:
2017-04-01
影响因子:
3.8
通讯作者:
Osorio, Lyda
Osorio, Lyda
中科院分区:
医学2区
文献类型:
--
作者:
del Mar Castro, Maria;Cossio, Alexandra;Osorio, Lyda

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锑酸葡胺(MA)和米替福新治疗皮肤利什曼病(CL)失败的报告在物种、人群和地理区域之间存在差异。本研究旨在确定临床,药物相关因素,利什曼原虫属与治疗失败的儿童和成人皮肤利什曼病。MethodsA队列研究进行了儿童(2-12岁)和成人(18-65岁)与CL,谁参加了临床研究在CIDEIM卡利,Tumaco和查帕拉尔。按治疗组和年龄组估计治疗失败的发生率。描述性,双变量,和多元Logistic回归分析进行了完整的队列和儿科patients.ResultsTwo百和三十例患者(米替福新:112; MA:118),其中60.4%是儿童和83.9%感染了L. V.巴拿马。治疗失败的总体发生率为15.65%(95% CI:10.92-20.38),米替福新组低于MA组(8.92%,95% CI:3.59-14.26 vs 22.03%,95% CI:14.48-29.58,p = 0.006)。治疗失败与年龄有关
IntroductionReports of therapeutic failure to meglumine antimoniate (MA) and miltefosine in cutaneous leishmaniasis (CL) varies between species, populations and geographic regions. This study aimed to determine the clinical, drug-related factors, and Leishmania species associated with treatment failure in children and adults with cutaneous leishmaniasis.MethodsA cohort study was performed with children (2-12 years old) and adults (18-65 years old) with CL, who have participated in clinical studies at CIDEIM Cali, Tumaco and Chaparral. Incidence of therapeutic failure was estimated by treatment and age groups. Descriptive, bivariate, and multiple logistic regression analyses were performed for the complete cohort and pediatric patients.ResultsTwo hundred and thirty patients were included (miltefosine: 112; MA: 118), of which 60.4% were children and 83.9% were infected with L.V. panamensis. Overall incidence of therapeutic failure was 15.65% (95% CI: 10.92-20.38), and was lower for miltefosine than for MA (8.92%, 95% CI: 3.59-14.26 versus 22.03%, 95% CI: 14.48-29.58, p = 0.006). Treatment failure was associated with age