Reductions in Skin and Systemic Parasite Burdens as a Combined Effect of Topical Paromomycin and Oral Miltefosine Treatment of Mice Experimentally Infected with Leishmania ( Leishmania ) amazonensis

Abstract

ABSTRACT This study aimed to investigate the activity of a combination of topical paromomycin gel and oral miltefosine for the treatment of experimental cutaneous leishmaniasis caused by Leishmania ( Leishmania ) amazonensis . The efficacy of the combination, evaluated by measuring lesion size and parasite burden in the skin and spleen, was assessed in BALB/c mice infected by L . ( L. ) amazonensis . The miltefosine was administered orally at 10 mg/kg of body weight/day for 10 days, while 10% paromomycin gel was applied topically twice a day for 20 days. Treatment of the experimentally infected animals with a topical paromomycin-oral miltefosine combination induced a statistically significant reduction in lesion size and parasite burden in the skin and spleen, with complete healing of ulcers, compared with those treated with a placebo group. A combination of topical paromomycin gel and oral miltefosine provided enhanced efficacy in the treatment of L. ( L. ) amazonensis -infected mice, showing activity higher than that observed for the monotherapeutic regimens.