**4.3 Chemotherapy**

Since an effective vaccine is unavailable for leprosy the secondary prevention (early treatment) becomes more important. Until 1981, Dapsone (Diamino Diphenyl Sulphone—DDS) was used to treat leprosy which resulted in the development of resistance and relapse, making leprosy control difficult.

Multidrug Therapy: In 1982, WHO recommended Multidrug Therapy (MDT) for all leprosy patients. Introduction of MDT has opened a new avenue in the control of leprosy in the world. Aim of MDT is to convert the infectious case into noninfectious as soon as possible, so as to reduce the reservoir of infection in the community.

The main objectives of MDT are:


The advantages of MDT over dapsone monotherapy are:


There are two types of MDT regimens used depending on the symptoms and signs shown by the patients - Paucibacillary (PB) and Multibacillary (MB). Recommended Regimens are discussed below [3, 5–7]:

i.Multibacillary leprosy:

MDT is recommended for following groups of patients:


The drugs used in Multibacillary MDT and dosages are:

Rifampicin: 600 mg once monthly, supervised. Dapsone: 100 mg daily, self administered. Clofazimine: 300 mg once monthly, supervised and 50 mg daily, self administered.

**135**

**Figure 3.**

*Leprosy: Prevention and Control*

bacteriological negativity.

children.

(**Figure 3**):

ii.Paucibacillary leprosy:

The drugs and dose schedule is:

single dose under supervision.

Rifampicin: 600 mg once a month.

Dapsone: 100 mg daily.

*MDT for adult MB type of leprosy [2, 7].*

Rifampicin 600 mg once a month for 6 months supervised. Dapsone 100 mg daily for 6 months self administered.

MDT is not contraindicated in patients with HIV infection.

dose under supervision and 50 mg daily for next 28 days. Dapsone 100 mg as single dose and then daily once for 1 month.

The standard adult treatment regimen for PB leprosy is (**Figure 4**):

Duration: 6 months (6 blister packs of 28 days each).

Each MDT blister pack contains tablets for 4 weeks treatment. For easy identification color coding of the blister pack is done, that is, with different colors for multibacillary and paucibacillary cases both in adults and

The treatment in both PB and MB cases varies depending on the age of the patient. The patients between 10 to 14 years are treated as paediatric cases, while >14 years are considered adult. The standard treatment regimen for MB leprosy in adults is given for 12 months. The drugs in each blister pack are

Two capsules of Rifampicin of 300 mg (600 mg once a month) to be taken as

Clofazimine 3 capsules of 100 mg each to be consumed once a month as single

Paucibacillary leprosy is treated for 6 months.

*DOI: http://dx.doi.org/10.5772/intechopen.92089*

Duration of treatment for Multibacillary leprosy is 12 months, can be extended to 18 months and continued where possible up to smear negativity. Sometimes LL/ BL patients with high bacilli may need 2–3 years or more of MDT for achieving
