Miltefosine or Antimonials: An in vitro Evaluation of Sensitivity against Leishmania tropica

Abstract

Antimony containing agents, meglumine antimoniate and sodium stibogluconate, are the first line of chemotherapy against cutaneous leishmaniasis in Pakistan. A comparison of the efficacy of these antimonials and miltefosine, the only oral therapy for leishmanisis was assessed in vitro. Eight different isolates of L. tropica were exposed to 4 different concentrations of the drugs for 48 hours under the standard conditions for L. tropica cultivation. At the end of exposure time, viability of the parasites was checked through XTT colorimetric assay. The efficacy of miltefosine stood matchless as compared to pentostam and glucantime; standard antimonial drugs. The average activity of miltefosine differed Significantly than the other standard drugs (miltefosine vs Glucantime p=0.003; miltefosine vs pentostam p=0.0045; glucantime vs pentostam p=0.006). The mean IC₅₀ values of mltefosine, glucantime and pentostam were respectively 1.476 ± 1.088μg/mL, 6.746 ± 2.438μg/mL and 85.970 ± 82.201μg/mL. Significant differences were noted in IC₅₀ of the drugs (miltefosine vs glucantime p=0.0003; miltefosine vs pentostam p=0.0242; glucantime vs pentostam p=0.0501). This study showed miltefosine as a more suitable option for treating L. tropica. This might be of practical importance in areas with higher prevalence of resistance to antimonials.