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Chapter 46 : Antibacterial Treatment of Leprosy

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Antibacterial Treatment of Leprosy, Page 1 of 2

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Abstract:

Acquired resistance of to the thioamides has been demonstrated in patients suffering from lepromatous leprosy treated with thioamides alone. Only the antibacterial treatment of leprosy, the principles on which it is based, the combinations with recommended antibiotics, and the results obtained to date in the field are discussed in this chapter. The whole argument behind modern chemotherapy of leprosy is based on the treatment of lepromatous or multibacillary leprosy, in the same way that the rationale for the chemotherapy of tuberculosis is based on the treatment of patients suffering from cavitary pulmonary tuberculosis. Dapsone, rifampin, and clofazimine therefore are automatically part of the initial phase of the chemotherapy of leprosy. From 10 at the beginning of treatment, the total number of viable bacilli in a patient suffering from multibacillary leprosy therefore fell to 10! The majority of susceptible bacilli and mutants resistant to dapsone and clofazimine, which by definition are susceptible to rifampin, were eliminated. The first reason for continuing treatment beyond the first doses of rifampin is to prevent the risk of selection of rifampin-resistant bacilli. The second reason is that after very short-term multidrug therapy in patients suffering from Bamako multibacillary leprosy, it was found that the shorter the duration of antibiotic administration, the earlier relapses occurred. It is difficult to reduce the duration of the multidrug therapy recommended by the WHO. It is based on the combination of the three best-tolerated antibiotics, rifampin, dapsone, and clofazimine, of which only rifampin is highly bactericidal.

Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
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Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
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Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
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Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
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Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
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Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
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Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
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Tables

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Table 1

Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
Generic image for table
Table 2

Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
Generic image for table
Table 3

Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
Generic image for table
Table 4

Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46
Generic image for table
Table 5

Citation: Grosset J. 2005. Antibacterial Treatment of Leprosy, p 1168-1178. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch46

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