Alternative antibiotic regimens for leprosy

Leprosy Mailing List – February 2^nd, 2010

Ref.: Alternative antibiotic regimens for leprosy

From: Wim H. van Brakel, Amsterdam , Netherlands

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Dear Dr. Gilead,

Thank you for your response (LML Jan. 27^th, 2010).

If patients are also unable to take dapsone or are dapsone resistant, that of course changes matters considerably. Such patients should be given at least one alternative effective antibiotic. I would fully support the combination suggested by Prof. Diana Lockwood in an earlier contribution (LML Jan. 27^th, 2010). I do not have personal experience with moxifloxacin or clarithromycin. There is (some) evidence of their efficacy, but they are very likely much more expensive than ofloxacin or minocyclin.

I do not see why Ethiopian patients should have a higher rate of dapsone resistance than patients from elsewhere. Ethiopia (where I did my leprosy training in the 1980s) was one of the first countries to switch over very quickly to MDT and has been using this for the last 24 years or so.

I hope this helps!

With kind regards,

Wim

Wim H. van Brakel

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