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[Acceptability, compliance and tolerance of daily polychemotherapy by leprosy patients in Guadeloupe].

From January 1980 to December 1984, 418 leprosy patients were treated in Guadeloupe with a daily multiple drug regimen using rifampin as an essential drug. The analysis of the data collected during this period of times gives the possibility of estimating the patient's approval, tolerance and attendance to this treatment. The approval is satisfactory in new cases of leprosy and in ancient cases relapsed under dapsone monotherapy but less in inactive ancient patients already treated with dapsone monotherapy. Attendance of the 418 patients to the multiple drug regimen is satisfactory too and similar to the attendance of patients treated with dapsone monotherapy in Guadeloupe and to the attendance of patients with monthly multiple drug regimen in another Caribbean country. Reactions did not occur with higher gravity or frequency than in patients under dapsone monotherapy. The high incidence of hepatitis (14%) due to the toxicity of protionamide in the combination rifampin-protionamide-dapsone make obligatory the monthly assessment of the liver functions in multibacillary patients treated with such a drug combination.

Chemical and Drug Induced Liver Injury↗

[Research in the campaign against leprosy (author's transl)].

"Leprosy Relief through Leprosy Research" means that the results of research are made available for curing and eradicating the disease. The "Marinum Model" and the "planter test in mice" are, along with determination of serum activity in healthy test subjects, part of a complex of experiments for the assessment of the therapeutic value of an antimycobacterial substance. This replaces the "controlled studies" which, in their proper form, are scarcely possible for leprosy. With the recently developed forms of combination therapy, the duration of leprosy treatment is reduced to a few years. Because of the relationship of Mycobacterium leprae to Mycobacterium tuberculosis, certain types of combination therapy can be used in both diseases at the same time.

Animals↗

[Long-term treatment of tuberculosis with isoprodian (author's transl)].

The results of combination therapy of Isoprodian with ethambul in patients with severe pulmonary tuberculosis were found to be comparable with the results previously obtained by us with other first-choice therapeutic regimens. 61% of the 140 cavities found before treatment disappeared within 5 months and 74% within 8 months of therapy. Disappearance of bacilli from the sputum was demonstrated in 89% of the patients by 12 weeks and in all patients by 20 weeks of treatment. The satisfactory therapeutic results, the low toxicity, the convenience of administration and, moreover, the economic aspect of the relatively lower cost of Isoprodian therapy justify the further use of Isoprodian supplemented with a first-choice tuberculostatic drug in the initial phase of treatment followed by long-term therapy with Isoprodian on its own in the stabilizing phase of even severe cases of tuberculosis.

Adolescent↗

[Combination drug therapy in leprosy].

The importance of polichemotherapy in multibacilar leprosy (LL and LD) in patients without any previous therapy as in those diagnosticated and under monotherapy most of all in the resistance patients is presented. Sulphones, clofazimine and rifampicine are selected as first rate drugs and protionamide-etionamide as second rate drugs. The therapy plans with the association of two and three drugs and the convenience of continuing indefinitely with at least one of the drugs are presented insisting on the advantages of the clofazimine-sulphones and rifampicine-sulphones associations. The necessity of immunotherapy for recover of celular immunity against the bacilus, is the only form of preventing relapses and drug resistance.

Clofazimine↗

Multi-drug therapy in leprosy: an effective method of control.

The steady increase in the prevalence of dapsone-resistant strains of leprosy threatens to undermine all the advances thus made for the control of this disease. Adoption of multidrug therapy, which can reverse this trend, is urgent.

Clofazimine↗