Pediatric Leprosy Medication

Updated: Aug 02, 2018
  • Author: Benjamin Estrada, MD; Chief Editor: Russell W Steele, MD  more...
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Medication

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.

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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

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.

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Antibiotics

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

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.

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Immunomodulators

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).

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