Treatment

General information on the treatment of leishmaniasis can be found on the CDC Leishmaniasis Resources for Health Professionals Web page.

Cutaneous leishmaniasis treatment options include local (applied to the lesions) and systemic (both oral and parenteral) therapies.

  • Types of local therapy include cryotherapy (cold) using liquid nitrogen, thermotherapy (heat) using localized current field radiofrequency, intralesional administration of pentavalent antimonial (SbV) compounds (not covered by CDC investigational new drug (IND) protocol for Pentostam®), and paromycin ointment.
  • Oral systemic therapy options include miltefosine, which is FDA approved but indicated for only three new world Leishmania species, and the following medications: ketoconazole, itraconazole, and fluconazole.
  • Parenteral treatment options include investigational antimonials, which must be administered under an IND protocol, and liposomal amphotericin B, which is FDA approved for visceral leishmaniasis.

Visceral leishmaniasis treatment options include liposomal amphotericin B (FDA approved for visceral leishmaniasis), and pentavalent antimonial (SbV) compounds.

Pentavalent antimonial (SbV) compounds, which have been used to treat leishmaniasis for many years, are not licensed for commercial use in the U.S. However, Pentostam®, which is used in many countries, will be provided to U.S. licensed physicians by the CDC Drug Service under an IND protocol.

MHS Leishmaniasis-Related Treatment Services

  • Pentostam® is administered under an IND protocol at Walter Reed National Military Medical Center and Brooke Army Medical Center.
  • Guidance for the management of suspected cutaneous leishmaniasis in the U.S. Army was published by the U.S. Army Medical Command (MEDCOM) in November 2010. The memorandum is accessible on Army Knowledge Online (requires a Common Access Card (CAC)).