Clofazimine and dapsone compliance in leprosy

Abstract

The regularity with which multibacillary patients, who were being treated with the WHO Study Group regimen in a THELEP-sponsored field trial in South India, ingested their prescribed daily clofazimine and dapsone was studied. The ingestion of clofazimine was monitored using a specially prepared formulation containing minute amounts of isoniazid as an innocuous marker. Overall drug acceptability and compliance was excellent. Approximately 75% of the prescribed daily clofazimine and dapsone doses were being ingested and it was concluded that only 5% of the patients would have benefited if their treatment had been supplemented by acedapsone injections. There was however a marked correlation between the self-administration of the 2 drugs with the consequence that the patients at greatest risk of developing rifampicin resistance because of poor dapsone complicance were the very ones most unlikely to take their daily clofazimine treatment. The results obtained emphasize the importance of employing regimens containing high degrees of supervised drug administration, especially in areas where drug compliance is known to be poor.