Indexed with PubMed and Science Citation Index (E) 
Users online: 324 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  Navigate here 
   Next article
   Previous article 
   Table of Contents
 Resource links
   Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
   Article in PDF (169 KB)
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

  In this article
   Article Figures

 Article Access Statistics
    PDF Downloaded176    
    Comments [Add]    
    Cited by others 3    

Recommend this journal


Year : 2007  |  Volume : 73  |  Issue : 1  |  Page : 53-54

Combination of sodium stibogluconate and rifampicin in post kala-azar dermal leishmaniasis

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
V K Sharma
Department of Dermatology and Venereology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0378-6323.30657

Rights and Permissions

How to cite this article:
Sharma V K, Prasad H, Sethuraman G, Khaitan B K. Combination of sodium stibogluconate and rifampicin in post kala-azar dermal leishmaniasis. Indian J Dermatol Venereol Leprol 2007;73:53-4

How to cite this URL:
Sharma V K, Prasad H, Sethuraman G, Khaitan B K. Combination of sodium stibogluconate and rifampicin in post kala-azar dermal leishmaniasis. Indian J Dermatol Venereol Leprol [serial online] 2007 [cited 2020 Jun 5];73:53-4. Available from: http://www.ijdvl.com/text.asp?2007/73/1/53/30657


Sodium stibogluconate (SSG) is the standard drug used for the treatment of post kala-azar dermal leishmaniasis (PKDL) at a dose of 20 mg/kg/day (maximum 850 mg/day) for at least 4 months. However, many patients are unable to complete the recommended duration of therapy because of the side effects such as elevated liver enzymes, proteinuria, and severe myalgia. It has been reported that up to 65% of the previously untreated patients fail to respond or promptly relapse after therapy with antimony compounds.[1],[2] Treatment with other drugs such as ketoconazole, amphotericin B, and allopurinol is also not satisfactory due to their side effects and prolonged therapy. In view of the above, the development of combination regimens for the treatment of PKDL has been proposed.[3],[4] We report the safety and efficacy of combination therapy with SSG 10 mg/kg/day I.V and rifampicin 900 mg daily orally for a period of 120 days in PKDL.

About eight male patients with an average age of 24.8 years (range 18-39 years) were included in this prospective hospital-based, descriptive preliminary study, which was carried out over a period of 2 years. The duration of skin lesions of PKDL ranged from 5 months to 10 years (mean 2.8 years). All the eight patients had a past history of kala-azar and the period of onset of PKDL after kala-azar varied from 6 months to 10 years (mean 2.81 years).

Hypopigmented macules and erythematous, shiny, succulent papules were present in all the patients and larger nodules were seen in four patients. The erythematous indurated lesions were present on the nose (7/8), chin (7/8), ears (6/8), external genitalia (4/8), glabella (2/8) and on the forehead, cheeks, lips (1 patient each). None of them had mucosal lesions or hepatosplenomegaly. Four of the eight patients had been treated previously with SSG at a dose of 600-1000 mg daily (two patients received for 90 days, one for 35 days and the other one for 10 days) without much response. Skin biopsy demonstrated a dermal infiltrate of lymphocytes, histiocytes, and plasma cells in all the patients. LD bodies were demonstrated in nodular lesions in four patients on tissue smears. Pulmonary tuberculosis was detected on chest X-ray in one patient.

About six patients completed the treatment as one of the patients developed leucopenia while the other was lost to follow up after 56 days. Five of them had an excellent response. The onset of the response was noted as early as 1 week and all the five patients had started responding by 3 weeks of therapy. Facial lesions healed completely in all cases by 3 months. The hypopigmented macules repigmented completely in three patients [Figure - 1]. The patient who was lost to follow-up after 56 days of therapy had 90% reduction in the facial lesions and 50% reduction in genital lesions. No recurrence was noted in the five patients who had an excellent response after a mean follow up period of 12 months (range 2 to 30 months).

The side effects due to the combination therapy were seen in five patients and were minor like myalgia (4/8), thrombophlebitis (3/8), headache (1/8), arthralgia (1/8), transient leucopenia (1/8), and elevated transminases (1/8).

Our report demonstrated an excellent response in five of the six patients who completed the treatment schedule without any relapse during the follow-up. The compliance was also good, with only one patient being lost to follow-up, probably as a result of reduced toxicity and earlier response. This preliminary study shows that the combination of SSG and rifampicin for 120 days is effective and reasonably safe in the treatment of PKDL.

  References Top

1.Control of leishmaniases. Report of a WHO expert committee. World Health Organ Tech Rep Ser 1990;793:1-158.  Back to cited text no. 1    
2.Sundar S, More DK, Singh MK, Singh VP, Sharma S, Makharia A, et al . Failure of pentavalent antimony in visceral leishmaniasis in India: Report from the center of Indian epidemic. Clin Infect Dis 2000;31:1104-7.  Back to cited text no. 2    
3.Ramesh V. Treatment of post- kala-azar dermal leishmaniasis. Int J Dermatol 1994;33:153-6.  Back to cited text no. 3  [PUBMED]  
4.Ramesh V, Mukherjee A. Post kala-azar dermal leishmaniasis. Int J Dermatol 1995;34:85-91.  Back to cited text no. 4  [PUBMED]  


[Figure - 1]

This article has been cited by
1 A retrospective study of intravenous sodium stibogluconate alone and in combinations with allopurinol, rifampicin, and an immunomodulator in the treatment of Indian post-kala-azar dermal leishmaniasis
Ramesh, V., Kumar, J., Kumar, D., Salotra, P.
Indian Journal of Dermatology, Venereology and Leprology. 2010; 76(2): 138-144
2 Oral miltefosine in post-kala-azar dermal leishmaniasis - experience in three cases : PKDL treated with oral miltefosine
Sujay Khandpur, Pankaj Chaturvedi, Uttam Kumar, Binod K. Khaitan, Jyotish C. Samantaray, Vinod K. Sharma
International Journal of Dermatology. 2010; 49(5): 565
[VIEW] | [DOI]
3 Enhancement of radiation-induced apoptosis of human lymphoma U937 cells by sanazole
Da-Yong Yu, Qing-Li Zhao, Zheng-Li Wei, Takaharu Nomura, Ikuo Kashiwakura, Tsutomu V. Kagiya, Takashi Kondo
APOPTOSIS. 2009; 14(5): 655
[VIEW] | [DOI]


Print this article  Email this article
Previous article Next article


Online since 15th March '04
Published by Wolters Kluwer - Medknow