A comparison between intralesional hypertonic Sodium Chloride solution and Meglumine Antimoniate (Glucantime) injections in the treatment of cutaneous Leishmaniasis

Background and objective: Different local and systemic modalities are suggested in the treatment of cutaneous leishmaniasis, but the pentavalent antimony compounds are still considered as the first line of treatment. Regarding to increase in clinical drug resistance and adverse effects, efforts to find a more effective and safer drug is continuing. The objective of this study was to compare the effect of intra-lesional hypertonic sodium chloride solution and intra-lesional meglumine antimoniate injections in the treatment of cutaneous leishmaniasis.Materials and Methods: This randomized controlled clinical trial with simple sampling method was performed on 72 patients with cutaneous leishmaniasis. The patients were randomly divided in two groups. One group was treated with intra-lesional hypertonic sodium chloride solution and the other one was treated with intra-lesional meglumine antimoniate injections at weekly intervals for 6 to 10 weeks. All patients were followed for 6 months after treatment.Results: After six weeks of treatment, complete improvement, partial improvement, and no response to treatment were 33.3%, 45% and 22% in meglumine antimoniate group and 26%, 23% and 51% in trial group, respectively. In both groups complete improvement was observed in lesions smaller than 2 cm². In lesions with partial improvement the treatment was continued up to 10 weeks and all patients were followed for six months. After six months ultimate cure rate was 52% in meglumine antimoniate group and 25% in hypertonic sodium chloride solution group.Conclusion: Injections of hypertonic sodium chloride solution has less efficacy in comparison with intra-lesional meglumine antimoniate in treatment of cutaneous leishmaniasis, but considering the good response in primary small lesions, it can be used as an alternative therapy in some special cases including small lesions and allergic reactions to meglumine antimoniate.