title: [Guidelines for the treatment of Hansen's disease in Japan (third edition)].
abstract: 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, 2010). 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) > 3 before treatment, 2 years treatment by rifampicin, dapsone and clofazimine (MDT/MB) is necessary. When BI becomes 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 > 3, 1 year treatment by MDT/MB is necessary. When BI becomes 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. Brief summary of diagnosis, purpose of therapy, character of drugs, and prevention of deformity is also described.
authors.affiliation: National Sanatorium Hoshizuka-Keiaien. masagoto@hoshizuka.hosp.go.jp
authors.forename: Masamichi
authors.initials: M
authors.lastname: Goto
authors.affiliation: National Kikuchi Keifuen Sanatorium.
authors.forename: Reiko
authors.initials: R
authors.lastname: Nogam
authors.affiliation: National Sanatorium Oku-Komyoen.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Okano
authors.affiliation: National Hansen's Disease Museum.
authors.forename: Masaichi
authors.initials: M
authors.lastname: Gidoh
authors.affiliation: National Center for Global Health and Medicine.
authors.forename: Rie
authors.initials: R
authors.lastname: Yotsu
authors.affiliation: Amakusa City Ushibuka Hospital.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ishida
authors.affiliation: Department of Pathology, Kagoshima University Hospital.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kitajima
authors.affiliation: Leprosy Research Center, National Institute of Infectious Diseases.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kai
authors.affiliation: Leprosy Research Center, National Institute of Infectious Diseases.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ishii
authors.affiliation: Department of Dermatology, Kyoto University.
authors.forename: Motoaki
authors.initials: M
authors.lastname: Ozaki
authors.affiliation: National Sanatorium Oku-Komyoen.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hatano
mesh_terms: D003191:Comprehensive Health Care; D000013:Congenital Abnormalities / Q000209:etiology / Q000517:prevention & control; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D006801:Humans; D007564:Japan; D007917:Leprostatic Agents / Q000008:administration & dosage*; D007918:Leprosy / Q000145:classification / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy*; D060046:Maintenance Chemotherapy / Q000379:methods / Q000592:standards; D013997:Time Factors
chemical_list: D007917:Leprostatic Agents