Leprosy
Mailing List – February 2nd,
2010
Ref.: Alternative
antibiotic regimens for leprosy
From:
Wim
H. van Brakel,
Amsterdam
,
Netherlands
Dear
Dr. Gilead,
Thank
you for your response (LML Jan. 27th, 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. 27th, 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
