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Pharmacotherapy for Multibacillary and Paucibacillary Leprosy
Multibacillary Leprosy (MB) Treatment
- Rifampicin: 10 mg/kg, once a month.
- Dapsone: 100 mg/day, daily use.
- Clofazimine: 50 mg/day, daily use for 12 months.
This combination therapy for multibacillary leprosy is aimed at killing the Mycobacterium leprae bacteria and preventing further nerve damage.
Paucibacillary Leprosy (PB) Treatment
- Rifampicin: 10 mg/kg, once a month.
- Dapsone: 100 mg/day, daily use for 6 months.
The shorter treatment regimen for paucibacillary leprosy reflects the lower bacterial load and less severe form of the disease.
Management of Lepra Reactions
Type 1 (Reversal Reaction)
- Corticosteroids: Prednisolone, 0.5 mg/kg/day, tapered gradually.
- NSAIDs: For managing inflammation and pain.
- Thalidomide: For severe cases to control the reaction.
Type 1 reactions typically occur in borderline leprosy patients, requiring a careful approach to reduce inflammation.
Type 2 (Erythema Nodosum Leprosum - ENL)
- Corticosteroids: Prednisolone, higher doses compared to Type 1 reactions.
- Thalidomide: Effective for recurrent or severe ENL reactions.
- NSAIDs: For fever and pain relief.
ENL reactions are more severe and typically involve systemic symptoms along with skin lesions.
General Management of Lepra Reactions
- Wound Care: Essential for preventing infections and managing skin lesions.
- Physiotherapy: Helps prevent contractures and improves function.
- Psychological Support: Critical for managing the emotional impact of leprosy.
Proper management of lepra reactions requires a holistic approach that includes medical, physical, and psychological care.
