Volume 81, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


As a participant in a multicenter trial, we evaluated the relapse rate in 189 multibacillary (MB) leprosy patients treated with four different regimens and followed-up for as many as 12 years after the initiation of treatment. Treatment regimens included 1 year of WHO MDT (a regimen including dapsone, clofazimine, and rifampin), 2 years of WHO MDT, 1 month of daily rifampin and daily ofloxacin, and 1 year of WHO MDT plus an initial 1 month of daily rifampin and daily ofloxacin. Relapse rates after 9 and 12 years from the initiation of therapy in the three regimens that included WHO MDT were 0–3%, whereas relapses occurred in those treated with the 1-month regimen alone at a significantly greater rate ( < 0.05): 11% at 9 years and 25% at 12 years. Relapses occurred late, beginning at 5 years after the initiation of therapy, and were confined to those patients histopathologically borderline lepromatous and polar lepromatous having a high bacterial burden. Prospects for an alternative effective short-course therapy of leprosy are presented.


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  1. Faget GH, Pogge RC, Johansen FA, Dinan JF, Prejean BM, Eccles CG, 1943. The promin treatment of leprosy: a progress report. Publ Health Rep 58 : 1729.
  2. Wolcott RR, Ross H, 1953. Exacerbation of leprosy during present day treatment. Int J Lepr Other Mycobact Dis 21 : 437–440.
  3. Pettit JHS, Rees RJW, 1964. Sulfone resistance in leprosy. An experimental and clinical study. Lancet ii : 673–674.
  4. Shepard CC, 1960. The experimental disease that follows the injection of human leprosy bacilli into foot-pads of mice. J Exp Med 112 : 445–454.
  5. Pearson JMH, Rees RJW, Waters MFR, 1975. Sulphone resistance in leprosy. A review of one hundred proved clinical cases. Lancet 2 : 69–72.
  6. Cree IA, Smith WCS, Rees RJW, Swanson Beck J, 1988. The influence of antimycobacterial chemotherapy on delayed hypersensitivity skin-test reactions in leprosy patients. Lepr Rev 59 : 145–151.
  7. Warndorff Van Diepen T, Aredath SP, Mengistu G, 1984. Dapsone-resistant leprosy in Addis Ababa: a progress report. Lepr Rev 55 : 149–157.
  8. Jacobson RR, Hastings RC, 1978. Primary sulfone resistance in leprosy. Int J Lepr Other Mycobact Dis 46 : 116.
  9. Guinto RS, Cellona RV, Fajardo TT, Dela Cruz EC, 1981. Primary dapsone-resistant leprosy in Cebu, Philippines. Int J Lepr Other Mycobact Dis 49 : 427–430.
  10. Gelber RH, Rea TH, Murray LP, Siu P, Tsang M, Byrd SR, 1990. Primary dapsone-resistant Hansen’s disease in California: experience with over 100 Mycobacterium leprae isolates. Arch Dermatol 126 : 1584–1586.
  11. World Health Organization, 1982. Chemotherapy of Leprosy for Control Programmes. Geneva: World Health Organization.
  12. Shepard CC, 1981. A brief review of experiences with short-term clinical trials monitored by mouse-footpad inoculation. Lepr Rev 52 : 299–308.
  13. Rees RJW, Pearson JMH, Waters MFR, 1970. Experimental and clinical studies on rifampicin in treatment of leprosy. BMJ 1 : 89–92.
  14. Shepard CC, Levy L, Fasal P, 1977. Rapid batericidal effect of rifampicin on Mycobaterium leprae. Am J Trop Med Hyg 21 : 446–449.
  15. World Health Organization Expert Committee on Leprosy, 1998. Seventh Report. Geneva: World Health Organization.
  16. Guelpa-Lauras CC, Perani EG, Giroir AM, Grosset TH, 1986. Activity of pefloxacin and ciprofloxacin against Mycobacterium leprae infection induced in mice. Int J Lepr Other Mycobact Dis 54 : 560–562.
  17. Gelber RH, Iranmanesh A, Murray L, Siu P, Tsang M, 1992. Activities of various quinolone antibiotics against Mycobacterium leprae in infected mice. Antimicrob Agents Chemother 36 : 2544–2547.
  18. Grosset JH, Ji B, Guelpa-Lauras CC, Perani EG, N’Deli LN, 1990. Clinical trial of pefloxacin and ofloxacin in the treatment of lepromatous leprosy. Int J Lepr Other Mycobact Dis 58 : 281–295.
  19. Fajardo TT Jr, Villahermosa LG, Dela Cruz EC, Cellona RV, Balagon MV, Abalos R, Gelber R, 2005. A clinical trial of pefloxacin and ofloxacin in lepromatous leprosy. Lepr Rev 73 : 389–391.
  20. Gelber RH, 1987. Activity of minocycline in Mycobacterium leprae-infected mice. J Infect Dis 156 : 236–239.
  21. Gelber RH, Murray LP, Siu P, Tsang M, Rea TH, 1994. A clinical trial of minocycline in lepromatous leprosy. BMJ 304 : 91–92.
  22. Franzblau SG, Hastings RC, 1988. In vitro and in vivo activities on macrolides against Mycobacterium leprae. Antimicrob Agents Chemother 32 : 1758–1762.
  23. Chan GP, Garcia-Ignacio BY, Chavez VE, Livelo JB, Jimenez CL, Parrilla ML, Franzblau SG, 1994. Clinical trial of clarithromycin for lepromatous leprosy. Antimicrob Agents Chemother 38 : 515–517.
  24. Gelber RH, Balagon VF, Cellona RV, 2004. The relapse rate in MB leprosy patients treated with 2 years of WHO-MDT is not low. Int J Lepr Other Mycobact Dis 72 : 493–500.
  25. Ridley DS, Jopling WH, 1966. Classification of leprosy according to immunity: a five-group system. Int J Lepr Other Mycobact Dis 34 : 255–273.
  26. Blumberg HM, Burman WJ, Chaisson RE, Daley CL, Etkind SC, Friedman LN, Fujiwara P, Grzemska M, Hopewell PC, Iseman MD, Jasmer RM, Koppaka V, Menzies RI, O’Brien RJ, Reves RR, Reichman LB, Simone PM, Starke JR, Vernon AA, 2003. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 167 : 603–662.
  27. Matsuoka M, Budiawan T, Saw K, Kyaw A, Tan EV, Dela Cruz E, Gelber R, Saunderson P, Balagon V, Pannikar V, 2007. The frequency of drug resistant mutations in Mycobacterium leprae isolates in untreated and relapsed leprosy patients in Myanmar, Indonesia, and the Philippines. Lepr Rev 78 : 343–352.
  28. Warndorff-van Diepen T, 1982. Clofazimine-resistant leprosy: a case report. Int J Lepr Other Mycobact Dis 50 : 139–142.
  29. Girdhar BK, Girdhar A, Kumar A, 2000. Relapses in multibacillary leprosy patients: effect of length of therapy. Lepr Rev 71 : 144–153.
  30. Jamet P, Ji B, 1995. Relapse after long-term follow up of multi-bacillary patients treated by WHO multidrug regimen. Marchoux Chemotherapy Study Group. Int J Lepr Other Mycobact Dis 63 : 195–201.
  31. Pattyn S, Grillone S, 2002. Relapse rates and a 10-year follow-up of a 6-week quadruple drug regimen for multibacillary leprosy. Lepr Rev 73 : 245–247.
  32. Consingy S, Bentoucha A, Pascale B, Grosset J, Ji B, 2000. Bactericidal activities of HMR 3647, moxifloxacin, and rifapentine against Mycobacterium leprae in mice. Antimicrob Agents Chemother 44 : 2919–2921.
  33. Pardillo FEF, Burgos J, Fajardo TT, Dela Cruz E, Abalos RM, Paredes RMD, Andaya CES, Gelber RH, 2008. Powerful bactericidal activity of moxifloxacin in human leprosy. Antimicrob Agents Chemother 52 : 3113–3117.

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  • Received : 29 Jan 2009
  • Accepted : 22 Apr 2009

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