A GUIDE TO ELIMINATING LEPROSY AS A PUBLIC HEALTH PROBLEM, Second Edition 1997 ‘Action Programme forthe Elimination of Leprosy ‘World Health Organization All registered and newly detected cases must be started on an appropriate MDT regimen atthe same time asthe diagnosis is confirmed, The WHO-MDT regimens are “robust”, ie. their efficacy is not impaired by minor irregularities in compliance. There is only one prerequisite to starting ‘an MDT programme: availability of MDT drugs. Treatment of leprosy with ‘only one anuileprosy drug will always result in development of drug resistance to that drug. Treatment with dapsone or ‘any other antileprosy drug used as ‘monotherapy should be considered as unethical practiceDT DRUG: J The drugs used in WHO-MDT are a combination of rifampicin, clofszimine ‘and dapsone for MB patients and of rifampicin and dapsone for PB patients. For patients classified as SLPB, one dose of a combination of rifampicin, ‘ofloxacin and minoeyeline (ROM) in blister-packs can be used. Among these, rifampicin is the most important drug nd therefore i neluded in the treatment all types of leprosy (CLOFAZIMINE Clofazimine is most active when ‘xdministered daily, is well-tolerated and Virtually non-toxic in the dasage used for MDT. The drug causes brownish-black discoloration and dryness of the skin but although this disappears within a few ‘months after stopping treatment it should, nevertheless, be explained 10 patients starting the MDT regimen for MB leprosy RIFAMPICIN ‘The drug is given once a month. Toxic effects have rarely been reported in the case of monthly administration, The ‘urine may be slightly reddish in colour for a few hours after its intake. This should be explained tothe patient when starting MDT. DAPSONE Daapsone is very safe in the dosage used in MDT. Side-effeets are rare but the main one is alle i reaction, causing itchy skin rashes and exfoliative dermatitis ‘Therefore, patents known to be allergic to any of the sulpha drugs should not be given dapsone.OFLOXACIN MINOCYCLINE This drug belongs to fluoroquinolone ‘This is a member of the tetracycline group of antibacterial agents. thas been group of antibiotics. This drug has found to be effective against leprosy in shown moderate activity against leprosy 1 dose of 400 mg. Side-effects ae rare bacilli in a dose of 100 mg. Most and mild in nature, these include common side-effect reported is trointestinal complaints, headache dizziness, which may last for few hours and dizziness. This drug is not after taking the drug, This drug is not recommended for use in pregnant recommended for use in pregnant ‘women and children below five yearsof women and children below five years of age. ae. Blister Pack for Multibacillary (MB) Patients MDT Drugs o