Two multidrug fixed-dosage treatment regimens with multibacillary leprosy patients

This study compares the clinical, bacilloscopic, and histopathological evolution of 140 patients classified as having multibacillary leprosy with no previous specific treatment who were submitted to two multidrug treatment regimens with a fixed dose. Regimen I-Group 1: 70 cases received 600 mg rifampicin (RMP) + 100 mg dapsone (DDS) daily for three consecutive months followed by 100 mg DDS daily, self-administered doses for 21 months. Regimen II-Group II: 70 cases received 600 mg RMP + 300 mg clofazimine (CLO) once a month under supervision plus self-administered doses of 50 mg CLO + 100 mg DDS daily for 24 months. The bacilloscopic, histopathological and neuromotor evaluation parameters showed no statistically meaningful differences (P > 0.05) between the two groups except for reaction frequency (P < 0.05) in that group II patients presented the least number of reactional episodes during the treatment and in the dermatological examination at discharge. Follow-up after treatment was carried out for a consecutive four year period. During routine clinical examination one case submitted to regimen I developed nodular skin lesion over the right arm. Skin biopsy was done for histopathological examination and mouse foot-pad experiment by Shepard technique. The drug susceptibility test with DDS and RPM showed that M. leprae strain isolated was susceptible to both the drugs.