Resistance developing in drug treatment for tropical skin disease

October 22, 2015

Dermal leishmaniasis is an ulcerous skin disease caused by a tropical parasite, all forms of which can be treated with the drug miltefosine. Researchers from the National Institute of Pathology, Indian Council of Medical Research and Safdarjung Hospital in Delhi studied the responses of 86 patients treated with miltefosine over 18 months that indicated a developing parasitic resistance to the drug, supporting a growing evidence base showing the rise of miltefosine resistance.

The researchers studied 86 patients - all confirmed to have post kala-azar dermal leishmaniasis. Patients were initially treated with 50 mg 3-times daily for 60 days however some patients suffered gastrointestinal side-effects and were changed to a dose of 50 mg of miltefosine twice daily for 90 days. Due to the side effects all patients from 2011 onwards were initiated onto this second regime.The patients were followed for 18 months post-treatment and assessed monthly via a clinical and histopathological examination.

73 patients successfully completed the treatment and were cured. 4% of patients suffered relapse in the first 12 months after treatment, while 15% relapsed in the 18 months following treatment with a higher relapse rate seen in patients on the 60 day treatment regime compared with the 90 day regime. The number of parasites pre-treatment was found to be higher in the patients who later suffered a relapse.

In six of the relapsed cases the researchers tested the susceptibility of the parasites to the miltefosine post-relapse and compared this with susceptibility of parasites pre-treatment. Following the relapse, parasites were shown to have significantly reduced sensitivity to the treatment, suggesting the development of resistance.

Although all the patients in the study were cured through the use of miltefosine the rate of relapse, along with the reduced drug susceptibility of the parasites following relapse, indicates that the development of drug resistance is a major concern. This indicates a pressing need for the development of new therapies or co-therapies to ensure the continued effective treatment of all forms of leishmaniasis.
-end-


PLOS

Related Parasites Articles from Brightsurf:

When malaria parasites trick liver cells to let themselves in
A new study led by Maria Manuel Mota, group leader at Instituto de Medicina Molecular, now shows that malaria parasites secrete the protein EXP2 that is required for their entry into hepatocytes.

How deadly parasites 'glide' into human cells
A group of scientists led by EMBL Hamburg's Christian Löw provide insights into the molecular structure of proteins involved in the gliding movements through which the parasites causing malaria and toxoplasmosis invade human cells.

How malaria parasites withstand a fever's heat
The parasites that cause 200 million cases of malaria each year can withstand feverish temperatures that make their human hosts miserable.

New studies show how to save parasites and why it's important
An international group of scientists published a paper, Aug. 1, 2020, in a special edition of the journal Biological Conservation that lays out an ambitious global conservation plan for parasites.

More flowers and pollinator diversity could help protect bees from parasites
Having more flowers and maintaining diverse bee communities could help reduce the spread of bee parasites, according to a new study.

How Toxoplasma parasites glide so swiftly (video)
If you're a cat owner, you might have heard of Toxoplasma gondii, a protozoan that sometimes infects humans through contact with contaminated feces in litterboxes.

Parasites and the microbiome
In a study of ethnically diverse people from Cameroon, the presence of a parasite infection was closely linked to the make-up of the gastrointestinal microbiome, according to a research team led by Penn scientists.

Clocking in with malaria parasites
Discovery of a malaria parasite's internal clock could lead to new treatment strategies.

Feeding bluebirds helps fend off parasites
If you feed the birds in your backyard, you may be doing more than just making sure they have a source of food: you may be helping baby birds give parasites the boot.

Scientists discover how malaria parasites import sugar
Researchers at Stockholm University has established how sugar is taken up by the malaria parasite, a discovery with the potential to improve the development of antimalarial drugs.

Read More: Parasites News and Parasites Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.