Treatment of tegumentary leishmaniasis in Brazil is limited to pentavalent antimonial, amphotericin B and pentamidine. These drugs, administered parenterally, cause several side effects and have a varied clinical response, depending on the species of Leishmania. Urgent expansion of the therapeutic arsenal against the disease is therefore necessary. Paromomycin is an aminoglycoside antibiotic that has already been approved for the treatment of visceral leishmaniasis in Southeast Asia. Here, we provide an in vitro evaluation of the activity of paromomycin in fifteen clinical isolates from patients with tegumentary leishmaniasis at a reference center for the treatment of the disease. Furthermore, the in vitro susceptibility to this drug in reference strains of Leishmania species that are endemic in Brazil has also been evaluated. Among the clinical isolates, nine were typed as Leishmania (Viannia) braziliensis, five as L. (Leishmania) amazonensis and one as L. (V.) guyanensis. Although never exposed to paromomycin, we found variable susceptibility among these isolates and reference strains in promastigotes and intracellular amastigotes, with the drug being more active in the amastigote form of the parasite. This study provides a preclinical dataset that is useful for the evaluation of paromomycin in the treatment of tegumentary leishmaniasis caused by species that are endemic in Brazil.

在巴西，皮下利什曼病的治疗仅限于五价锑，两性霉素B和喷他idine。肠胃外给药的这些药物会引起多种副作用，并且根据利什曼原虫的种类而具有不同的临床反应。因此，迫切需要扩大针对该疾病的治疗性阿森纳。巴龙霉素是一种氨基糖苷类抗生素，已被批准用于治疗东南亚的内脏利什曼病。在这里，我们提供了在参考中心治疗该病的十五例临床上分离性利什曼病患者中巴龙霉素活性的体外评估。此外，该药物在参考菌株中的体外敏感性还对巴西特有的利什曼原虫物种进行了评估。其中临床分离株，九人类型为利什曼原虫（Viannia）braziliensis，五象湖（利什曼原虫）亚马孙和一个为L.（V.）guyanensis。尽管从未接触过巴龙霉素，但我们在前鞭毛体和胞内变形虫中的这些分离株和参考菌株中发现了不同的敏感性，该药物在寄生虫的a体形式中更具活性。这项研究提供了临床前数据集，可用于评估巴龙霉素在治疗由巴西特有种引起的皮状利什曼病的治疗中。