Leprosy
Mailing List – January 27th, 2010
Ref.: Alternative
antibiotic regimens for leprosy
From:
Leon Gilead,
Jerusalem
,
Israel
Dear
Dr. van Brakel,
Thank
you for your response (LML Jan. 21st , 2010).
The
problems arise with patients refusing clofazimine (Lamprene) while
being unable to take dapsone due to haemolysis or other side effects. There
may also be a problem with double-drug therapy of Rifampicine and
Dapsone in cases where the M. leprae are Dapsone resistant to begin
with (about 70% of our patients in the last decade are Ethiopian
immigrants, and as you are well aware, I'm sure, Dapsone resistance is
quite common in Ethiopia), and hence we may actually get a Rifampicine
monotherapy! This is
especially problematic since we don't have the lab setting to check in
vitro whether this resistance actually exists in our patients.
What
is your approach, and of other readers?
Has anyone a relevant input, regarding Prof. Ji Baohong's
suggested alternative MDT regimen? It
is composed of Rifampicine 600mg, Moxifloxacin 400mg and
Clarithromycin 1gr or Minocycline 200gr all of which X1/month.
It was suggested in a lecture given at the 17th ILC at Hydrabad
2008
–
Ref: http://www.aifo.it/english/resources/online/books/leprosy/ila-india08/new-drugs-Ji_Bahong.pdf
-.
Prof.
Gelber reported, in the same meeting, about his experiments with
Moxyfloxacin, and later published his observations (one of the
publications abstract is in the following ref: -
(http://www.ncbi.nlm.nih.gov/pubmed/18573938?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=2)
.-
Have
you, or anyone else for that matter, tried this regimen or other
regimens in clinical settings? If
anyone has, were there any side effects or other problems observed?
Thanks
again for your input.
Leon
Dr.
Leon Gilead
Director
of the Israeli Hansen's Disease Center
Department
of Dermatology
Hadassah
University
Hospital
Jerusalem
Israel
