Ambulatory treatment of multibacillary leprosy with a regimen of 8 months duration

An ambulatory treatment regimen for multibacillary leprosy, of 34 weeks duration composed of 8 weeks daily supervised rifampicin, ethionamide (ETH), dapsone (DDS) and clofazimine (CLO) followed by 26 weeks of unsupervised ETH, DDS and CLO, introduced in 1983 has been evaluated; 268 patients were followed for a mean of 4.4 years and a total of 1188 patient years. The relapse rate was 0.33 per 100 patient years of follow up. The reduction of the duration of the combined administration of RMP + ETH reduced the hepatotoxicity to 1.4%. It is possible that both phases of the regimen studied could still be reduced, however, in the near future ETH will be replaced by alternative bactericidal drugs, avoiding the hepatotoxicity.