Ofloxacin containing combined drug regimens in the treatment of multibacillary leprosy.

The results of ofloxacin containing combined drug regimens in the treatment of 60 multibacillary leprosy cases from January 1989 to June 1995 are reported. The objective of the trial is to compare the antileprotic property of ofloxacin and rifampicin in multibacillary leprosy patients and to study the killing rate of M. leprae by ofloxacin and rifampicin before mass treatment can be recommended. The complications and side-effects of ofloxacin and rifampicin were of a mild nature and both drugs were well tolerated. Moderate to marked clinical improvement was noticed in a short period with ofloxacin containing regimens in multibacillary leprosy patients. No persisters were detected in any of the 33 specimens (of mouse footpads) that had been obtained after treatment for 6 months. Ofloxacin if added to the currently used WHO recommended MB-MDT regimen may shorten the duration of treatment. Ofloxacin, therefore, may be considered as a suitable alternative in suspected/proven rifampicin resistant cases and where rifampicin is contraindicated. The results were evaluated on the basis of the clinical conditions, mycobactericidal effectiveness, signs of drug toxicity and side effects.

Combined chemotherapy trials with regimens containing ofloxacin and rifampicin for multibacillary leprosy patients.

The results of combined chemotherapy trials with regimens containing ofloxacin and rifampicin for the treatment of 60 multibacillary leprosy cases from January 1989 to September 1995 was reported. Clinical improvement was achieved by all regimens from the end of the first month. Most patients continued to improve for 3 years. Bacterial indices were gradually reduced during the treatment. Patients on regimens containing rifampicin were clear of M. leprae at the end of the 5th year. The complications and side-effects of ofloxacin and rifampicin were trivial and both drugs were well tolerated. Ofloxacin added to the current WHO recommended M.B.-MDT regimen may shorten the duration of treatment. Ofloxacin may be an alternative in suspected/proven rifampicin resistant cases or rifampicin contraindicated.

Leprosy situation in Thailand.

The prevalence rate of leprosy in Thailand was approximately 5 per 1,000 in 1953. Specialized leprosy control programme was first launched in 1956 in Khon-Kaen Province and gradually expanded to cover the whole country in 1972. After successful control, it has been partially integrated in provincial health services in 1971 and fully integrated into primary health care system in 1976. Effective case finding in combination with chemotherapy using WHO multidrug therapy regimen and health education have brought about a decline in the prevalence of the disease to only 0.537 per 1,000 in 1987. However, the estimated prevalence rate by random survey is approximately twice the number of registered cases. Reduction in number of lepromatous leprosy patients, particularly the new cases, decrease in number of patients with deformities caused by leprosy and increased number of patients who voluntarily came to attend at the treatment centres imply the successful control at a certain level. It is then justified to aim at the goal of eradication of leprosy by combination of chemotherapy, immunotherapy and immunoprophylaxis with antileprosy vaccines in the future.