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Lepra (leprosy): treatment
Last reviewed: 23.04.2024
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Leprosy is treated according to the following monthly schedule. On the first day, three drugs are prescribed: dapsone (100 mg), rifampicin (600 mg) and clofazimine (300 mg), and on the following days for a month - two drugs (100 mg dapsone and 50 mg clofazimine). Then the cycle is repeated (without interruption). The duration of the course is at least two years (before the disappearance of M. Leprae in the biopsy of the skin). Patients with the tuberculoid and borderline tuberculoid form of leprosy are prescribed two drugs from the very beginning: the first day, 100 mg of dapsone and 600 mg of rifampicin, and then, within a month, a 100 mg dapsone. In Ukraine, a group of sulfonic-type drugs produces a dimocyphone. As second-line drugs for the treatment of leprosy patients, ethionamide and protionamide are used. For the relief of acute leprosy reactions, glucocorticoids, NSAIDs, analgesics, vitamins, agents that improve nerve conduction and prevent the development of muscle atrophy, desensitizing drugs and immunomodulators are prescribed. Additional treatment of leprosy is used according to indications - physiotherapeutic (treatment of neuritis) and surgical (osteomyelitis).
What is the prognosis of leprosy?
Leprosy has a favorable prognosis with a timely diagnosis. Later diagnosis and untimely treatment of leprosy lead to disabling effects. With early diagnosis and good tolerability of combined treatment, work ability does not suffer.
Clinical examination
Patients who are on dispensary registration, at least twice a year, should be examined by a doctor-leprologist or dermatologist. Periodically, according to the decision of the antileprosary institution that observes the patient, he is prescribed a counter-specific specific leprosy treatment, and general restorative measures are performed. Rest in balneological sanatoria for patients who completed treatment is contraindicated.
Memo for the patient
Patients, especially those with dermatologic dysfunction, should examine their limbs on a daily basis in order to detect injuries and burns in a timely manner and conduct appropriate treatment. They should regularly take the prescribed anti-relapse chemotherapy courses, despite subjective well-being and lack of signs of disease activation.
How is leprosy prevented?
There is no specific prevention of leprosy with vaccines or sera. The primary task of anti-lethality measures is active detection and treatment of leprosy. In the endemic zones, mass inspections, sanitary and educational work are carried out, programs of controlled outpatient treatment are implemented, which significantly reduce the risk of spreading the leprosy infection. Antigenic proximity of pathogens of leprosy and tuberculosis formed the basis for the vaccination of newborn BCG for the prevention of leprosy.