Efficacy of Extended (Six Weeks) Treatment with Miltefosine for Mucosal Leishmaniasis in Bolivia

We investigated whether increasing the period of follow-up or increasing the duration of therapy would markedly alter the 71% cure rate of mucosal leishmaniasis in Bolivia consequent to treatment with miltefosine for 4 weeks. Increasing the follow-up from 12 months to 24 months demonstrated additional relapse in only 2 of 41 patients. Increasing the period of therapy from 4 weeks to 6 weeks only increased the cure rate to 75%. The cure rate of mucosal leishmaniasis in Bolivia, whether 4 or 6 weeks of therapy is used and whether 12 month or 24 months follow up is conducted, is approximately 70%.