Chemotherapy of leprosy: theoretical basis of new guideline in Japan

Abstract

For the effective treatment of leprosy, we should consider that (1) more time is needed for the elimination of bacilli than ordinary bacterial infection, (2) bactericidal therapy often induces host immunity called reactions, (3) rapid treatment is needed for the reactions. Last year, 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. For multibacillary(MB) with bacterial index (BI > or = 3) before treatment, 2 years treatment by rifampicin, dapsone and clofazimine (MDT/MB) is necessary. When BI decrease is not satisfactory(BI value decrease < 2 steps, or final BI > or = 3) after 2 years, MDT/MB should be continued until BI negativity and loss of active lesions. Theoretical background of our proposal is described.