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Abstract
Objective: Cutaneous leishmaniasis (CL), a neglected tropical disease, poses a significant therapeutic challenge in endemic regions. Although intralesional meglumine antimoniate (MA) remains a standard treatment, its drawbacks necessitate the exploration of safer and, cheaper alternatives. This within-patient comparative study aimed to evaluate the efficacy of intralesional 0.2% ciprofloxacin compared with that of intralesional meglumine antimoniate in the treatment of CL.
Methods: A six-month comparative study was conducted at the Dermatology Department of a tertiary care hospital in, Malir Cantt, Karachi. A total of 128 patients with confirmed cutaneous leishmaniasis were enrolled. Only patients presenting with at least two lesions located on the contralateral sides of the body were included. Right-sided lesions were treated with intralesional 0.2% ciprofloxacin (Group A), whereas while left-sided lesions received intralesional meglumine antimoniate (Group B). Injections were administered every fifth day until re-epithelialization commenced. The primary outcome was the proportion of lesions achieving a complete clinical response (>75% reduction in size without induration) at eight weeks post-treatment initiation.
Results: The mean age of the participants was 30.6 ± 7.1 years, with a male predominance (78.9%). The complete response rate was 88.3% (113/128) in the ciprofloxacin group and 91.4% (117/128) in the meglumine antimoniate group. The difference in efficacy was not statistically significant (p-value = 0.486). Stratification by demographic and clinical variables revealed no significant differences in response rates across any subgroup.
Conclusion: Intralesional ciprofloxacin demonstrated comparable efficacy to that of intralesional meglumine antimoniate in the treatment of cutaneous leishmaniasis. Given its lower cost and favorable safety profile, ciprofloxacin may be a viable alternative therapeutic option, particularly in resource-constrained settings.
Keywords: Cutaneous Leishmaniasis; Ciprofloxacin; Meglumine Antimoniate; Injections, Intralesional; Treatment Outcome
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