The Diagnosis and Management of Dapsone-resistant Leprosy

Abstract

Based on experience gained with some 120 proven dapsone-resistant patients, the clinicai and bacteriological diagnosis of secondary sulphone resistance is described, and the differential diagnosis discussed. The various findings in the clinicai trial and experimental proof of sulphone resistance are interpreted according to the pharmacokinetics of dapsone resistance in le promatous (LL and BL) leprosy. The results of treatment of dapsone-resistant patients with cJofazimine (for over 13 years) and with rifampicin (for up to 8.5 years) are compare d and contrasted, an d the scientific basis for future altemative regimens is brief1y discussed.