Guideline for the treatment of Hansen's disease in Japan.

DOI PubMed 15 Citations 34 References
  • Goto Masamichi
    Department of Pathology, Faculty of Medicine, Kagoshima University ad hoc committee on treatment guideline and judgement of cure, Japanese Leprosy Association
  • Ishida Yutaka
    International Medical Cooperation Bureau, International Medical Center ad hoc committee on treatment guideline and judgement of cure, Japanese Leprosy Association
  • Gidoh Masaichi
    National Institute for Infectious Disease, Leprosy Research Center ad hoc committee on treatment guideline and judgement of cure, Japanese Leprosy Association
  • Nagao Eiji
    National Hansen's Disease Sanatorium, Ohshima-Seishoen ad hoc committee on treatment guideline and judgement of cure, Japanese Leprosy Association
  • Namisato Masako
    National Hansen's Disease Sanatorium, Tama-Zenshoen ad hoc committee on treatment guideline and judgement of cure, Japanese Leprosy Association
  • Ishii Norihisa
    National Institute for Infectious Disease, Leprosy Research Center ad hoc committee on treatment guideline and judgement of cure, Japanese Leprosy Association
  • Ozaki Motoaki
    Hyogo Prefectural Amagasaki Hospital ad hoc committee on treatment guideline and judgement of cure, Japanese Leprosy Association

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  • ハンセン病治療指針

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Abstract

ad hoc committee of Japanese Leprosy Association recommends standard treatment protocol of leprosy in Japan, which is a modification of World Health Organization's multidrug therapy (WHO/MDT, 1997). For paucibacillary (PB) leprosy, 6 months treatment by rifampicin and dapsone (MDT/PB) is enough. However, for high bacterial load multibacillary (MB) leprosy, 12 months treatment seems insufficient. Thus, (A) For MB with bacterial index (BI) ≥3 before treatment, 2 years treatment by rifampicin, dapsone and clofazimine (MDT/MB) is necessary. (A-1) When satisfactory decrease of BI (BI value decrease≥2 steps, or final BI<3) is obtained after completion of 2 years MDT/MB, maintenance therapy by dapsone and clofazimine is recommended until BI negativity and loss of active lesions. (A-2) When BI decrease is not satisfactory (BI value decrease <2 steps, or final BI≥3), MDT/MB should be continued until BI negativity and loss of active lesions. (B) For MB with BI<3 or fresh MB (less than 6 months after the onset of the disease) with BI≥3, 1 year treatment by rifampicin, dapsone and clofazimine (MDT/MB) is necessary. (B-1) When BI become negative and active lesion is lost within one year, no maintenance therapy is necessary. (B-2) When BI is still positive or active lesion is remaining, additional therapy with MDT/MB for one more year is recommended. Brief summary of diagnosis, purpose of therapy, character of drugs, and prevention of deformity is also described.

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