Paucibacillary multidrug therapy in leprosy. 7 1/2 years experience

Three hundred and twenty-three paucibacillary (PB) leprosy patients were treated with WHO-recommended multidrug therapy (MDT) and followed up for over 7 1/2 years. The paucibacillary MDT regimen (PBR) was well accepted and tolerated. Complete clinical regression was attained in 61.2% patients after 6 doses of PBR. Persistence of clinical activity after 6 months of therapy was associated with occurrence of type I upgrading reaction, presence of six or more patches and more than two thickened major nerve trunks. Reversal reactions were encountered in 15.9% patients, one third of which were accompanied by severe neuritis. Delayed upgrading reaction occurred in six patients, two patients had relapse one and two years after stopping of PBR. The WHO recommended MDT regimen for paucibacillary cases needs careful evaluation and it may be necessary to extend the treatment beyond six months in certain situations.