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The latest time bound WHO regimens for the treatment of paucibacillary (I, TT, BT) and multibacillary leprosy is discussed. The rationale, indications of above regimens and cautions necessary are highlighted.
Prolonged administration of isoniazid, protionamide and rifampicin to white rats is accompanied by marked depression of myocardial contractile function determined by the distress of membranous mechanisms of calcium transport because of excessive activation of lipid peroxidation in cardiomyocyte biomembranes. Administration of ionol coupled with antituberculous drugs prevents their cardiotoxic effects.
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Thirty lepromatous patients were treated during 3 months. If clinical condition was notably improved, the bacillary index and the morphologic index remained almost un-changed and the histo-pathological features, advanced concurrently to the clinic aspects.
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No additive effect was found at the addition of isoniazid to either dapsone or protionamide against M. leprae and against highly dapsone-sensitive in vitro growing Mycobacterium sp. strains. It is concluded that the indication of the administration of isoniazid in leprosy is extremely limited and could only be envisaged as a companion drug in combined therapy of dapsone-resistant multibacillary leprosy in light-skinned people, when aminoglycosides cannot be administered.
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Experimental and clinical studies showed that there were rapidly and slowly growing, as well as persisting mycobacteria, including variants in L-forms. Combinations of isoniazid, streptomycin and PAS mainly affected rapidly growing variants of mycobacteria, while isoniazid and rifampicin in combination with streptomycin, protionamide or ethambutol had the most pronounced bacteriostatic effect on all mycobacterial variants. Discontinuation of the bacteria isolation was observed by the end of the 4th, 6th and 9th months of the treatment in 73.9, 93 and 96 per cent of the newly recorded patients with cavernous tuberculosis respectively. Closing of the caverns in the same periods was observed in 26.1, 68.4 and 81.4 per cent of the patients. In patients with rapid discontinuation of the bacteria isolation, i. e. within the first 3 months of the treatment a rapid closing of the caverns was also recorded.
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