[Guideline for the treatment of Hansen's disease in Japan (Second edition)].
ad hoc committee of Japanese Leprosy Association recommends revised 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. When BI become negative and active lesion is lost within 2 years, no maintenance therapy is necessary. When BI is still positive, one year of MDT/MB is added (3 years in total), followed by maintenance therapy by dapsone and clofazimine 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 MDT/MB is necessary. When BI become negative and active lesion is lost within one year, no maintenance therapy is necessary. When BI is still positive or active lesion is remaining, additional therapy with MDT/MB for one more year is recommended. This is a simplification of first version in 2000. Brief summary of diagnosis, purpose of therapy, character of drugs, and prevention of deformity is also described.
Goto
Masamichi
M
Department of Human Pathology, Kagoshima University Graduate School of Dental and Medical Sciences, Kagoshima, Japan. masagoto@m2.kufm.kagoshima-u.ac.jp
Nogami
Reiko
R
Hatano
Kentaro
K
Okano
Yoshiko
Y
Ishii
Norihisa
N
Gidoh
Masaichi
M
Ishida
Yutaka
Y
Ozaki
Motoaki
M
D002991:Clofazimine / Q000008:administration & dosage; D000013:Congenital Abnormalities / Q000517:prevention & control; D003622:Dapsone / Q000008:administration & dosage; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D006801:Humans; D007564:Japan; D007917:Leprostatic Agents / Q000008:administration & dosage; D007918:Leprosy / Q000145:classification / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D012293:Rifampin / Q000008:administration & dosage; D013514:Surgical Procedures, Operative
D007917:Leprostatic Agents; D003622:Dapsone; D002991:Clofazimine; D012293:Rifampin