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Pediatric Leprosy Medication

  • Author: Benjamin Estrada, MD; Chief Editor: Russell W Steele, MD  more...
Updated: Sep 30, 2013

Medication Summary

Prolonged therapeutic regimens have traditionally been recommended in the treatment of leprosy; however, recommendations by the World Health Organization (WHO) now focus on regimens with shorter duration both for tuberculoid (TT) or paucibacillary (PB) leprosy and for lepromatous (LL) or multibacillary (MB) leprosy.

The drugs that are more frequently used in the treatment of leprosy include rifampin, dapsone, clofazimine, ofloxacin, minocycline, and clarithromycin. Multidrug therapy is required in all cases to prevent antimicrobial resistance.


Antitubercular Agents

Class Summary

Any regimen must contain multiple drugs to which Mycobacteriumtuberculosis is susceptible. Guidelines for preventing the transmission of Mtuberculosis are available. In addition, the therapy must be taken regularly and continued for a sufficient period.

Rifampin (Rifadin)


Rifampin, also called rifampicin, inhibits RNA synthesis in bacteria by binding to the beta subunit of DNA-dependent RNA polymerase, which, in turn, blocks RNA transcription.



Dapsone is a competitive para-aminobenzoic acid (PABA) antagonist. It prevents formation of folic acid, causing bacterial growth inhibition.

Clofazimine (Lamprene)


Clofazimine binds preferentially to mycobacterial DNA. It was discontinued from the US market in 2005 but is now available as an orphan product.



Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting. Antibiotics with efficacy against mycobacteria are used.



Ofloxacin is a pyridine carboxylic acid derivative with broad-spectrum bactericidal effect.

Minocycline (Dynacin, Minocin, Solodyn)


Minocycline treats infections caused by susceptible gram-negative and gram-positive organisms, in addition to infections caused by susceptible Chlamydia, Rickettsia, and Mycoplasma species.

Clarithromycin (Biaxin)


Clarithromycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest. Treatment with clarithromycin for 56 days has been demonstrated to be effective in eliminating more than 99.9% of M leprae present before treatment.



Class Summary

These agents modulate immune reactions resulting from diverse stimuli.

Thalidomide (Thalomid)


Thalidomide is an immunomodulatory agent that may suppress excessive production of tumor necrosis factor alpha (TNF-α) and may downregulate selected cell-surface adhesion molecules involved in leukocyte migration. It is approved for the treatment of erythema nodosum leprosum (ENL).

Contributor Information and Disclosures

Benjamin Estrada, MD Professor, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Infectious Diseases, University of South Alabama College of Medicine, University of South Alabama Children's and Women's Hospital

Benjamin Estrada, MD is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Larry I Lutwick, MD Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Gary J Noel, MD Professor, Department of Pediatrics, Weill Cornell Medical College; Attending Pediatrician, New York-Presbyterian Hospital

Gary J Noel, MD is a member of the following medical societies: Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

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Infiltration of ear lobes in patient with lepromatous leprosy.
Man with advanced deformities caused by unmanaged leprosy: keratitis, loss of eyebrow, thickened skin, and typical hand impairments. Ho Chi Minh City, Vietnam. Image courtesy of D. Scott Smith, MD.
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