(Last Updated On: December 13, 2018)

Authors:  Cybill Dianne C. Uy, MD1, Erin Jane L. Tababa, MD1, Belen L. Dofitas, MD

Abstract

Background: Leprosy continues to pose a public health problem, especially in developing countries. Although the overall incidence of newly diagnosed cases have declined significantly, the rate of decline has been static. This static rate of decline, and an increasing number of persister cases and relapses, are thought to be brought about by increasing antibiotic resistance.

Objective: To assess the efficacy of non-MDT therapeutic options used in managing adult patients diagnosed with paucibacillary leprosy.

Methods: We searched extensively for the terms PAUCIBACILLARY LEPROSY and (rifampicin or ofloxacin or minocycline or others or non-MDT or alternative). Two reviewers examined all retrieved trials independently for eligibility and quality. There were four studies included in the meta-analysis. The outcomes measured were the clinical improvement, relapse, lepra reactions and adverse events.

Results and Conclusion: Non-MDT treatment regimens for paucibacillary leprosy provide a promising alternative to the WHO-recommended regimen to prevent further antibiotic resistance and poor compliance. However, careful surveillance and follow up, especially for occurrence of relapses must be done.

Citation

Uy, C, Tababa, E. & Dofitas, B. (2017). Non-MDT treatment for paucibacillary leprosy: a systematic review and meta-analysis of randomized controlled trials. Journal of the Philippine Dermatological Society, 26(2), 22-29.

 

Keywords

leprosy, treatment, MDT-PB, Hansen’s disease

  1. Balagon MF, Cellona RV, Abalos RM, Gelber RH, Saunderson PR. The efficacy of a four-week, ofloxacin-containing regimen compared with standard WHO-MDT in PB leprosy. Lepr Rev. 2010;81(1):27-33.
  2. Sagun S and Dofitas B.  . Prevalence of delayed lepra reactions after completion of 1-year vs 2-year MDT in Philippine General Hospital: a five year retrospective study. 2012.
  3. Bolognia JL JJaSJ. Bolognia Textbook of Dermatology 3rd ed ed. Spain: Mosby Elsevier Publishing; 2012.
  4. Scollard DM, Adams LB, Gillis TP, Krahenbuhl JL, Truman RW, Williams DL. The continuing challenges of leprosy. Clin Microbiol Rev. 2006;19(2):338-81.
  5. Ji B, Perani EG, Petinom C, N’Deli L, Grosset JH. Clinical trial of ofloxacin alone and in combination with dapsone plus clofazimine for treatment of lepromatous leprosy. Antimicrob Agents Chemother. 1994;38(4):662-7.
  6. Jacobson RR. Needed research in chemotherapy of leprosy related to the individual patient. Int J Lepr Other Mycobact Dis. 1996;64(4 Suppl):S16-20.
  7. Gelber RH, Fukuda K, Byrd S, Murray LP, Siu P, Tsang M, et al. A clinical trial of minocycline in lepromatous leprosy. BMJ. 1992;304(6819):91-2.
  8. Lesion Multicentre Trial G. A comparative trial of single dose chemotherapy in paucibacillary leprosy patients with two to three skin lesions. Indian J Lepr. 2001;73(2):131-43.
  9. Girdhar A, Kumar A, Girdhar BK. A randomised controlled trial assessing the effect of adding clarithromycin to rifampicin, ofloxacin and minocycline in the treatment of single lesion paucibacillary leprosy in Agra District, India. Lepr Rev. 2011;82(1):46-54.
  10. Manickam P, Nagaraju B, Selvaraj V, Balasubramanyam S, Mahalingam VN, Mehendale SM, et al. Efficacy of single-dose chemotherapy (rifampicin, ofloxacin and minocycline-ROM) in PB leprosy patients with 2 to 5 skin lesions, India: randomised double-blind trial. Indian J Lepr. 2012;84(3):195-207.
  11. Mane I, Cartel JL, Grosset JH. Field trial on efficacy of supervised monthly dose of 600 mg rifampin, 400 mg ofloxacin and 100 mg minocycline for the treatment of leprosy; first results. Int J Lepr Other Mycobact Dis. 1997;65(2):224-9.
  12. Majumder V, Saha B, Hajra SK, Biswas SK, Saha K. Efficacy of single-dose ROM therapy plus low-dose convit vaccine as an adjuvant for treatment of paucibacillary leprosy patients with a single skin lesion. Int J Lepr Other Mycobact Dis. 2000;68(3):283-90.

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