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Leprosy (cont.)

Leprosy Treatment

Leprosy is a curable disease using the highly effective MDT (multidrug therapy).

  • In 1981, a World Health Organization Study Group recommended multidrug treatment with three medications: dapsone, rifampicin (Rifadin), and clofazimine (Lamprene).
  • This long-term treatment regimen cures the disease and prevents the complications associated with leprosy if started in its early stages.
  • These medications have been distributed free to all patients with leprosy since 1995, and the WHO distributes the medications in convenient monthly calendar blister packs.
  • After the first doses of these medications, patients are no longer infectious and they do not transmit the disease to others.
  • Widespread resistance of M. leprae to a full course of MDT has not developed.

The WHO currently recommends different treatment regimens for patients with paucibacillary leprosy and multibacillary leprosy.

  • WHO recommendations
    • Paucibacillary single-lesion leprosy
      • A single dose of rifampicin, ofloxacin (Floxin), or minocycline (Dynacin, Minocin, Minocin PAC, Myrac, Solodyn)
    • Paucibacillary leprosy
      • Six months of treatment using rifampicin (monthly) and dapsone (daily)
    • Multibacillary leprosy
      • Twelve months of treatment using rifampicin (monthly), dapsone (daily), and clofazimine (daily)

In the U.S., the recommended treatment regimens by the National Hansen's Disease Program for both paucibacillary leprosy and multibacillary leprosy differ from the WHO recommendations.

  • U.S. recommendations
    • Paucibacillary leprosy
      • Twelve months of treatment using rifampicin (daily) and dapsone (daily)
    • Multibacillary leprosy
      • Twenty-four months of treatment using rifampicin (daily), dapsone (daily), and clofazimine (daily)
  • Individuals who develop type 1 or type 2 reactions may require other medications.
    • Type 1 reaction (reversal reaction)
      • Treatment may include the use of corticosteroids, salicylates, and nonsteroidal anti-inflammatory drugs (NSAIDs).
    • Type 2 reaction (ENL)
      • Treatment may include the use of corticosteroids, salicylates, NSAIDs, clofazimine, and thalidomide (Thalomid).
Medically Reviewed by a Doctor on 9/19/2014
Medical Author:

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