Leprosy Mailing List – January 27th, 2010
Ref.: Alternative antibiotic regimens for leprosy
From: Leon Gilead,
Dear Dr. van Brakel,
Thank you for your response (LML Jan. 21st , 2010).
The problems arise with patients refusing clofazimine (Lamprene) while being unable to take dapsone due to haemolysis or other side effects. There may also be a problem with double-drug therapy of Rifampicine and Dapsone in cases where the M. leprae are Dapsone resistant to begin with (about 70% of our patients in the last decade are Ethiopian immigrants, and as you are well aware, I'm sure, Dapsone resistance is quite common in Ethiopia), and hence we may actually get a Rifampicine monotherapy! This is especially problematic since we don't have the lab setting to check in vitro whether this resistance actually exists in our patients.
What is your approach, and of other readers? Has anyone a relevant input, regarding Prof. Ji Baohong's suggested alternative MDT regimen? It is composed of Rifampicine 600mg, Moxifloxacin 400mg and Clarithromycin 1gr or Minocycline 200gr all of which X1/month. It was suggested in a lecture given at the 17th ILC at Hydrabad 2008
– Ref: http://www.aifo.it/english/resources/online/books/leprosy/ila-india08/new-drugs-Ji_Bahong.pdf -.
Prof. Gelber reported, in the same meeting, about his experiments with Moxyfloxacin, and later published his observations (one of the publications abstract is in the following ref: -
Have you, or anyone else for that matter, tried this regimen or other regimens in clinical settings? If anyone has, were there any side effects or other problems observed?
Thanks again for your input.
Dr. Leon Gilead
Director of the Israeli Hansen's Disease Center
Department of Dermatology
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