Objective: To describe the effectiveness and safety of treatment for cutaneous leishmaniasis in patients over the age of 44 years treated at a specialized research center in Colombia. Methods: Clinical profiles of cutaneous leishmaniasis patients were retrospectively described and effectiveness and safety of systemic and local and systemic treatments were compared with Pearson's Chi-square test or Fisher's exact test. Results: A total of 151 patients were included and 65% were male, 78% were over 50 years of age, 28% had hypertension and 11% had diabetes. The main treatments were systemic glucantime (10%), miltefosine (15%), and local treatments (48%). Treatment effectiveness was 68% for systemic and 64% for local treatments. Patients on systemic treatments had a significantly higher frequency of systemic adverse events. In contrast, those on local treatments only showed a statistically higher proportion of vesicles in application site. Conclusions: Our findings show moderate effectiveness across treatments. Crucially, while systemic and local treatments had similar effectiveness, systemic treatments were associated with a significantly higher frequency of adverse events. This finding highlights that local therapies offer a safer alternative for older adults, making them a viable and potentially preferable first-line option to minimize toxicity in this vulnerable population.
López‐Carvajal et al. (Wed,) studied this question.