Leprosy Mailing List – May 29, 2015
Ref.: (LML) Alternative MDT drugs and treatment duration
From: Grace Warren, Sidney, Australia
Dear Pieter,
I have just been thrown a problem patient to deal with.- by correspondence.
It concerns a person from Indonesia who came to Australia about 5 years ago. He says he had anaesthetic patches on his knees when he came but no one bothered and it was only 2 years ago that a student of mine did slit skin smear and got 5+ !!!! We gather that he was BBish initially. We assume he had downgraded for by the time she saw him he had nodules and was BL\\LLish!
He was put onto Rifampicin, Clarithromycin and Clofazamine (he has dapsone allergy!! So we cannot give that – and was already anaemic on arrival!) ). He does not like the pigmentation of the Clofazamine! We think he has been taking it because of the skin colour but he does not want to take any more! New smears just done are still 2-3+ and the Medical Department boss agrees that we do not stick to the WHO limit on drug duration so I was wondering what your LML readers would recommend in drugs. I feel that if we give the Clofazamine he will not take it regularly; we cannot give dapsone; Rifampicin and Clarithromycin should be ok but so far his progress is slow. Have you any other recommendations and are any other drugs available? I am not in a situation now where I always hear the latest and in fact am confined to hop myself with a fractured ankle. Thanks Pieter I am always interested in notes, in LML, from round the world and as you know send notes sometimes when I think I can contribute.
With thanks,
Grace Warren
Previously consultant with the Leprosy Mission.
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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