Maryam Khalili; Saman Mohammadi; Mohamadhosein Saeidi; Rezvan Amiri; Amireh Heshmatkhah; Simin Shamsi Meymandi; Mahin Aflatoonian
Abstract
Background: Treatment failure of antimony drugs for anthroponoticcutaneous leishmaniasis (ACL) is rising. Recognizing predictivefactors of unresponsiveness to treatment can substantiallyinfluence better ACL management. The goal of this study wasto investigate predictive factors associated with treatment ...
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Background: Treatment failure of antimony drugs for anthroponoticcutaneous leishmaniasis (ACL) is rising. Recognizing predictivefactors of unresponsiveness to treatment can substantiallyinfluence better ACL management. The goal of this study wasto investigate predictive factors associated with treatment failurein ACL in Kerman, southeast Iran.Methods: This case-control study was conducted retrospectivelyon 2,128 ACL cases in Kerman over ten years from 2011 to 2020.The case group included patients whose lesions failed to resolveafter one treatment course. The control group included thosewhose lesions were cured after one treatment course.Results: Treatment failure was observed in 13.5% of cases (10.7%of systemic therapy and 16.7% of local therapy). No significantdifference was reported between the type of treatment andtreatment failure. The association of treatment failure withwinter-onset (P = 0.001, OR = 1.39, CI = 1.23–1.56), face (P = 0.001,OR = 1.86, CI = 1.38–2.49), ulceration (P = 0.01, OR = 0.51, CI = 0.30–0.85), small diameter (P = 0.005, OR = 0.57, CI = 0.38-0.84) andlong duration of lesions (P = 0.01, OR = 1.57, CI = 1.11–2.21) wasvalidated by multivariate logistic regression analysis.Conclusion: Efficient detection and timely management of ACLcases are essential to reduce resistant cases, as lesions lastinglonger than four months show poor response to treatment.Furthermore, early treatment of facial lesions with systemictherapy is suggested to optimize results and reduce the risk ofdisfiguring scars. Further surveys are required to determine thereason behind more treatment failure in winter-onset lesions.
