Leprosy Mailing List – February 3, 2018
Ref.: (LML) Chemoprophylaxis in Leprosy
From: Diana Lockwood, London, UK
Dear Pieter,
Regarding the risk of inducing resistance in Mycobacterium tuberculosis with SDR prophylaxis, I would like to thank Wim (LML, January 27, 2018) for posting the article from Infectious Disease of Poverty.1 This is a commentary by a group of experts. The article is a description of what happens when people have TB and TB treatment. What is needed is a data-based analysis of the numbers of patients being treated for TB in countries with proposed roll out of single dose Rifampicin (SDR) as PEP. This should include modelling of the numbers of extra doses of Rifampicin that will need to be given in these settings. This will be millions of doses of Rifampicin because of the numbers of people involved when household contacts are treated. Then the risk of Rifampicin resistance can be calculated. This level of opinion rates as a grade 3 using the Oxford level of evidence criteria.2
1. Mieras L, Anthony R, van Brakel W, Bratschi MW, van den Broek J, Cambau E, et al. Negligible risk of inducing resistance in Mycobacterium tuberculosis with single-dose rifampicin as post-exposure prophylaxis for leprosy. Infect Dis Poverty. 2016 Jun 8;5(1):46
2. https://www.cebm.net/wp-content/uploads/2014/06/CEBM-Levels-of-Evidence-2.1.pdf
Best Wishes
Diana Lockwood
Professor of Tropical Medicine,
London School of Hygiene and Tropical Medicine
(Note editor: there is a possibility that my computer has been hacked. Be aware of phishing mails!)
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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