Evaluating the efficacy of Glucantime and determinants of treatment success in cutaneous leishmaniasis: A retrospective study.

BACKGROUND

Cutaneous leishmaniasis (CL) is a major public health issue in endemic regions such as Shiraz, Iran. Glucantime (meglumine antimoniate), a pentavalent antimonial remains the first-line treatment. However, its efficacy varies depending on the route of administration and patient-specific factors. This study aimed to evaluate the clinical effectiveness of Glucantime and identify predictors of treatment success among patients with CL.

METHODS

This retrospective cross-sectional study, included 70 patients diagnosed with CL in 2024 at a major referral centre. Diagnosis was confirmed via PCR-based molecular detection and direct microscopic parasitological examination. Patients were treated with Glucantime, administered either intradermally or intramuscularly, based on standardized protocols. Demographic data, lesion characteristics, and treatment outcomes were recorded. Treatment success was defined as ≥50 % reduction in lesion size and resolution of symptoms at four months. Statistical analyses were performed using chi-square tests, with significance set at p < 0.05.

RESULTS

Among the 70 patients (mean age of 32.6 ± 19 years; 53 % female), the overall treatment success rate was 65.7 %. Females demonstrated a significantly higher response rate than males (78.8 % vs. 54.1 %, p = 0.03). Intradermal administration yielded significantly better outcomes (91.4 %) compared to intramuscular injections (40 %, p < 0.001). No statistically significant associations were observed with age, lesion size, number, or morphology, although smaller lesions and blister-type lesions tended to respond better.

CONCLUSIONS

Glucantime showed moderate clinical effectiveness for CL treatment, with intradermal administration demonstrating superior outcomes compared to intramuscular delivery. Although intradermal therapy should be prioritized for suitable lesions, the moderate overall efficacy highlights the need for alternative or adjunctive treatments. Findings should be interpreted with appropriate caution and further prospective studies are warranted to confirm these results and refine treatment protocols.