MDT: duration of treatment FAQ
What is meant by fixed duration treatment for MB and PB patients?
Fixed duration treatment for MB patients means that after taking 12 monthly doses of MDT this person is cured and should be removed from the register. Similarly, for PB patients, after taking 6 monthly doses of MDT this person is cured and should be discharged.
What is the reason for giving MDT to PB patients for six months?
In PB patients six months of rifampicin by itself should be satisfactory, theoretically, to kill all the organisms. However, dapsone has been added in order to avoid rifampicin resistance in patients who are wrongly classified as PB.
Is it necessary to give MDT to PB patients until clinical inactivity is achieved?
No, it is not necessary to give MDT to PB patients until clinical inactivity. PB patients can be cured in 6 months with the WHO-MDT regimen. It should be recognized that clinical activity in PB leprosy does not necessarily imply direct correlation with bacterial multiplication. In a large proportion of patients it is not possible to achieve clinical inactivity in six months even though all the organisms are killed. The evidence from the follow-up of PB patients in THEMYC-supported field trials of MDT shows that the lesions become inactive gradually over a period of one to two years after the treatment has been discontinued. The occurrence of relapses in PB patients is very low and, as yet, there is no established relationship between disease activity status at the time of completing treatment and subsequent relapses. Nevertheless, it is important that the initial classification of patients designated as having paucibacillary leprosy is accurate.