Effectiveness of MDT: FAQ
Is WHO-recommended multidrug therapy (MDT) the best combination available for treatment of multibacillary (MB) and paucibacillary (PB) leprosy in leprosy control today?
Yes, it is the best combination available today, as proved by its successful application in leprosy control under varying conditions since 1982. The combination not only cures leprosy but is also highly cost-effective. The recommended standard regimen for multibacillary (MB) leprosy is: Rifampicin: 600 mg once a month Dapsone: 100 mg daily Clofazimine: 300 mg once a month, and 50 mg daily Duration: 12 months. The recommended standard regimen for paucibacillary (PB) leprosy is: Rifampicin: 600 mg once a month Dapsone: 100 mg daily Duration: 6 months. Children should receive appropriately reduced doses of the above drugs.
What is the evidence that MDT is effective in MB and PB leprosy?
The most important indicator for the effectiveness of a chemotherapeutic regimen is the rate of occurrence of relapse following successful completion of the scheduled course of treatment. The information available to WHO, from a number of control programmes, shows that the relapse rate is very low (0.1% per year for PB and 0.06% per year for MB on the average). In addition, the low frequency of side-effects has made it highly acceptable to patients in a variety of settings.
What are the basic principles in using multidrug therapy for the treatment of leprosy?
In developing WHO MDT regimens, three main principles were adhered to: rifampicin should be one of the components of MDT rifampicin 600 mg should be given at least once a month to all patients at least two anti-leprosy drugs should be used in the MB regimen and one anti-leprosy drug should be used in the PB regimen, in addition to rifampicin, in order to prevent the occurrence of rifampicin-resistant M. leprae.