Leprosy medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Medical Therapy

Independently of the class of leprosy, every patient should receive multidrug therapy, and never be treated with a single drug. Multidrug therapy, or MDT, is a safe and effective combination of oral drugs to treat leprosy, that at the same time aim to prevent drug resistance. In order to improve adherence to the treatment is it distributed for free. This combination is provided in blister packs, in order to facilitate the process.

This treatment regimen is identical both to adults and children, simply with a change in dosage of the drugs and is safe for pregnant women or those who are breastfeeding. This treatment does not interfere with the treatment for HIV, nor TB, however, in this last case, if a leprosy patient is also being treated for tuberculosis with rifampin, then rifampin should be omitted from the MDT regimen.

It is important to emphasize the importance of adherence to this regimen, in order to avoid development of resistance to the medication. For the monthly administered drugs, their administration should be supervised by an health care practitioner at a local clinic. During this visit, it is also important to evaluate the patient for potential complications of the disease, such as neuritis, or any possible reaction to the medication.

The MDT regimen will be slightly deferent, depending on the classification of leprosy:

• Paucibacillary patients - MDT consists of 2 drugs, taken for 6 months.

• Multibacillary patients - MDT consists of 3 drugs, taken for 12 months.

People who need MDT may be divided into:

• New cases:

• Those who have never received MDT in the past.

• Other cases:

• Relapsed cases - will repeat previous MDT regimen.
• Previous paucibacillary cases, now returning as multibacillary patients.
• Patients who did not complete due MDT regimen, shall receive the same MDT regimen as new cases.
• Transfered patients - these should carry a record of the current treatment to date, in order for this to be continued.

Multidrug Therapy

Multibacillary Leprosy   ▸  Adults   ▸  Children <10 years old   ▸  Children >10 years old Paucibacillary Leprosy   ▸  Adults   ▸  Children <10 years old   ▸  Children >10 years old

Adults Preferred Regimen ▸ Rifampicin 600 mg once a month PO PLUS ▸ Clofazimine 50 mg/day PO and 300 mg once a month PO PLUS ▸ Dapsone 100 mg/day PO Children <10 years old Preferred Regimen† ▸ Rifampicin 10 mg/Kg once a month PO PLUS ▸ Clofazimine 1 mg/Kg/day PO and 6 mg/Kg once a month PO PLUS ▸ Dapsone 2 mg/Kg/day PO Children >10 years old Preferred Regimen† ▸ Rifampicin 450 mg once a month PO PLUS ▸ Clofazimine 50 mg every other day PO and 150 mg once a month PO PLUS ▸ Dapsone 50 mg/day PO Adults Preferred Regimen ▸ Rifampicin 600 mg once a month PO PLUS ▸ Dapsone 100 mg/day PO Children<10 years old Preferred Regimen† ▸ Rifampicin 10 mg/Kg once a month PO PLUS ▸ Dapsone 2 mg/Kg/day PO Children >10 years old Preferred Regimen† ▸ Rifampicin 450 mg once a month PO PLUS ▸ Dapsone 50 mg/day PO

References

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