[Guideline for the treatment of Hansen's disease in Japan].
Ad hoc committee of Japanese Leprosy Association recommends standard treatment protocol of leprosy in Japan, which is a modification of World Health Organization's multidrug therapy (WHO/MDT, 1997). For paucibacillary (PB) leprosy, 6 months treatment by rifampicin and dapsone (MDT/PB) is enough. However, for high bacterial load multibacillary (MB) leprosy, 12 months treatment seems insufficient. Thus, (A) For MB with bacterial index (BI) > or = 3 before treatment, 2 years treatment by rifampicin, dapsone and clofazimine (MDT/MB) is necessary. (A-1) When satisfactory decrease of BI (BI value decrease > or = 2 steps, or final BI < 3) is obtained after completion of 2 years MDT/MB, maintenance therapy by dapsone and clofazimine is recommended until BI negativity and loss of active lesions. (A-2) When BI decrease is not satisfactory (BI value decrease < 2 steps, or final BI > or = 3), MDT/MB should be continued until BI negativity and loss of active lesions. (B) For MB with BI < 3 or fresh MB (less than 6 months after the onset of the disease) with BI > or = 3, 1 year treatment by rifampicin, dapsone and clofazimine (MDT/MB) is necessary. (B-1) When BI become negative and active lesion is lost within one year, no maintenance therapy is necessary. (B-2) When BI is still positive or active lesion is remaining, additional therapy with MDT/MB for one more year is recommended. Brief summary of diagnosis, purpose of therapy, character of drugs, and prevention of deformity is also described.
Goto
M
M
Department of Pathology, Faculty of Medicine, Kagoshima University, Sakuragaoka, Kagoshima, Japan. imasagoto@m2.kufm.kagoshima-u.ac.jp
Ishida
Y
Y
Gidoh
M
M
Nagao
E
E
Namisato
M
M
Ishii
N
N
Ozaki
M
M
D004359:Drug Therapy, Combination; D006801:Humans; D007917:Leprostatic Agents / Q000008:administration & dosage*; D007918:Leprosy / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D014944:World Health Organization
D007917:Leprostatic Agents