Antimicrobial Adjuvants to Revert the Imbalance of Skin Microbiota for Improved Outcomes of Complicated Cutaneous Leishmaniasis Treatment in Ethiopia

Inclusion Criteria

• •Inclusion:
• •Clinical diagnosis of CL
• •Need for systemic treatment (1 or more of these criteria)
• •* Mucosal involvement of lesion or at risk for mucosal involvement (\< 1 cm from the nose, eyes and vermillion border of the lips)
• •* Lesion size \>4 cm
• •* \>4 lesions
• •* Lesions on joints or fingers
• •* Lesions previously not responding to local treatment
• •* Lesions unsuitable for local treatment (e.g., eyelids)
• •* Lesions with signs of dissemination (satellite lesions, nodular lymphangitis, sporotrichoid pattern)
• •Age \> 4 (minimum age to receive systemic treatment with SSG)
• •At least one lesion eligible for treatment\* (meeting all criteria below)
• •* lesion with surface change, including ulcerated, crusted and scaly lesions
• •* distinguishable from other lesions (minimum 0.5 cm apart)
• •* no mucosal involvement against which a topical agent would likely not be effective (e.g., lesions that are located too deep within the nasal passages or on the inner lip, where proper application is challenging and the ointment may be easily removed or not adequately absorbed)
• •Willing and able to provide informed consent. For participants under the age of 18, parental or caregiver consent is required. Additionally, assent must be obtained from adolescents aged 12 to 17
• •Willing to be hospitalized for 4 weeks
• •Exclusion:
• •DCL patients