Alternative antibiotic regimens for leprosy

Leprosy Mailing List – January 21^st, 2010

Ref.: Alternative antibiotic regimens for leprosy

From: Wim H. van Brakel

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Dear Dr. Gilead,

Unless there is suspicion of antibiotic resistance to either dapsone or rifampicin, it is not necessary to replace the clofazimine component of MB MDT. People get better on double drug therapy just as well as they do on MDT, because most of the MDT effect is due to rifampicin. The only time you will miss the clofazimine component is when a patient is prone to develop ENL. We see many former patients nowadays who develop ENL reactions after their 12-month regimen has been completed, just due to the withdrawal of clofazimine.

With friendly greetings,

Wim van Brakel

Wim H. van Brakel, MD MSc PhD

Royal Tropical Institute
Leprosy Unit
and

Athena Institute

Faculty of Earth and Life Sciences

VU University

Correspondence address:

Wibautstraat 137k

1097DN Amsterdam
Netherlands
tel +3120 6939297

fax +3120 6680823
w.v.brakel(at)kit.nl

wim.van.brakel(at)falw.vu.nl