Leprosy
Mailing List, December 2nd, 2008
Ref.: Steroid
therapy in the management of reactions in leprosy.
From: de Koning P.,
Würzburg
,
Germany
Dear
colleagues,
The
guidelines for treatment of leprosy reactions urgently need to be
reviewed. For treatment
in the field 12 weeks of prednisolone (in blister packs) is
recommended by WHO for both type I and type II reactions. Evidence suggests that this is
either not long enough (for type I) or too long and with an
insufficiently high starting dose (type II).
For “severe
reaction“ the recommendation is that a patient should be referred to
experts and treated for “3-6 months“. However, these experts are
becoming increasingly rare, and most health workers at grass root
level follow the 12-week guideline, which is probably as good as doing
nothing at all.
Kind regards,
Dr. Pieter de
Koning
Medical
Advisor
DAHW,
Würzburg
,
Germany
