ABSTRACT
Polymerase chain reaction (PCR) for the detection of Mycobacterium leprae was applied to fresh skin biopsies and slit-skin smears from 122 untreated leprosy patients. The PCR positivity rates in biopsies were 95.6% in multibacillary (MB) cases and 44.2% in paucibacillary (PB) cases. Following 1 month of treatment, MB cases declined by 54.3% and PB cases by 61.8% of initial values. Six-month values also declined from initial positivity rates to 50.3% and 53.8% of initial values in MB and PB, respectively. Larger declines in the rate of positivity were seen for skin-smear samples at 1 and 6 months in both MB and PB, but overall PCR positivity rates were lower than biopsy rates for M. leprae.
Subject(s)
DNA, Bacterial/analysis , Leprosy/diagnosis , Mycobacterium leprae/genetics , Polymerase Chain Reaction , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Leprosy/drug therapy , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
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.
Subject(s)
Leprostatic Agents/therapeutic use , Leprosy/drug therapy , Leprosy/microbiology , Ofloxacin/therapeutic use , Rifampin/therapeutic use , Adolescent , Adult , Aged , Animals , Child , Dose-Response Relationship, Drug , Female , Humans , Leprostatic Agents/pharmacology , Male , Mice , Mice, Nude , Middle Aged , Ofloxacin/pharmacology , Rifampin/pharmacology , Thailand , Time Factors , Treatment OutcomeABSTRACT
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.
