The Investigation of Safety and Efficacy of Fluconazole in Treatment of Types of Cutaneous Leishmaniasis : A Systematic Review

Background: Leishmaniasis is a major public health issue. The new Leishmaniasis treatment guidelines suggest meglumine antimoniate as the first line treatment for Leishmaniasis which has less therapeutic indexes and higher unwanted effects. Fluconazole as an effective and safe oral treatment has low toxicity and also is safety-approved.Objectives: Our aim is to evaluate the safety and efficacy of fluconazole in treatment of types of cutaneous Leishmaniasis (CL).Materials and Methods: We conducted a literature search on databases like Pubmed, Web of Science, Embase in order to evaluate the safety and efficacy of fluconazole in treatment of types of cutaneous Leishmaniasis. The references in published clinical trials were included in the study.Results: This study showed that patients with CL caused by L braziliensis, fluconazole has longer healing time compared to the placebo and the cure rateand healing time is dosage dependent. Another study showed that fluconazole at the dosage of 400mg/day is more effective than at the dosage of 200. Nausea was bothering at the high dosages. A RCT has shown that a 6-week course of oral fluconazole of 200 mg daily dosage is effective for CL treatment caused by L major and shortens the time of healing compared to placebo. In another study, fluconazole failed at the dose of 450mg per day in treating patients with CL caused by L guyanensis. Most of them developed a worsening of ulcers and lymphatic spreading of the disease. Fluconazole was well tolerated and safe in most of the patients and there weren t any significant side effects.Conclusion: This study demonstrated that oral fluconazole is effective against the L braziliensis and L major types but fails against the L guyanensis. Fluconazole is a cheap drug so that can be an alternative drug from an economic standpoint in treating Leishmaniasis.

کلیدواژه ها:

Safety ، Efficacy ، Fluconazole ، and Leishmaniasis