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26 Although gentamicin is not directly cytocidal to leishmania parasites, it may attenuate them, facilitating immunologic mechanisms of eradication through helper T-cell immunity.27,28 In addition, combination products might impart broad-range antibacterial activity against secondary bacterial infections that could otherwise delay wound healing, and such products may avert the advancement of resistance. In a previous stage 2 study, WR 279,396 was far better than vehicle control against L. Major infections29 at the same site in Tunisia of which the WHO formulation was ineffective.5 percent gentamicin cream) with paromomycin alone and with vehicle-control cream against cutaneous leishmaniasis due to L.