Leprosy, caused by Mycobacterium leprae, is a chronic mycobacterial infection that is completely treatable with the right multidrug therapy (MDT). So now for exam preparation and clinical understanding, it’s very important to remember clearly that the treatment duration, drug procedure, and the proper management of leprosy reactions.
Okay, so let’s break it down in a very simple, and structured way.
Standard Treatment: Multidrug Therapy (MDT)
Both multibacillary (MB) and paucibacillary (PB) leprosy are highly treated with three drugs.
The only difference between them is the duration of treatment:
- Multibacillary (MB) leprosy – 12 months
- Paucibacillary (PB) leprosy – 6 months
The drug combination that always remains the same.
Drug Regimen and Dosage Schedule
Supervised Monthly Dose (Given at Health Center)
Once in every month, in the presence of a healthcare worker:
- Rifampicin 600 mg
- Clofazimine 300 mg
These doses are highly overseen to make sure the compliance.
Daily Unsupervised Home Dose (28 Days)
The patient is given the medication to take at home for the next 28 days:
- Clofazimine 50 mg once daily
- Dapsone 100 mg once daily
After 28 days:
- The patient returns it to the health facility.
- The empty blister pack is checked.
- Then the next supervised monthly dose is regulated.
- Another 28-day supply is highly provided.
This cycle continues:
- For 12 months in MB cases
- For 6 months in PB cases
Leprosy Reactions: Type 1 and Type 2
Leprosy patients may develop with the immunological reactions during treatment:
- Type 1 reaction (Reversal reaction)
- Type 2 reaction (Erythema Nodosum Leprosum – ENL)
Drug of Choice for Both Reactions:
Steroids
Although steroids help to control the inflammation and stave off nerve damage.
Most Important Clinical Point
Even if a patient has develops a reaction:
Continue multidrug therapy (MDT)
Do NOT stop leprosy treatment
The steroids are added, not substituted. But the MDT must be continued along with the steroid therapy until the reaction is moderate.
Conclusion
Leprosy is a completely remediable disease, but it is only possible when it should be managed with proper multidrug therapy and strict compliance with treatment protocols. Although the key principles are very simple: they use the standard three-drug regimen and regularly follow the correct duration which is based on disease classification, also make sure that use supervised monthly dosing, and never discontinue MDT, even during leprosy reactions. If you get the identification of reactions and timely addition of steroids, prevent lot of complications such as nerve damage and disability. Along with such structured treatment and patient compliance, a successful cure is not just possible, it is expected.