Malathi Munisamy, Thappa Devinder Mohan
Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Indian J Dermatol. 2013 Mar;58(2):93-100. doi: 10.4103/0019-5154.108029.
Leprosy has been considered a curable disease after the implementation of multidrug therapy (MDT), which has been proven to be safe and effective, by bringing about a significant change in the global and national scenario of leprosy by upgrading the control of leprosy to the next stage of eradication. Since its introduction, the MDT regimens for the treatment of leprosy have undergone several changes especially with regard to the duration of treatment. The advantages of shortened duration of treatment need to be balanced against the risk of relapse and a lot of controversies exist pertaining to this aspect. The fixed-duration (FD) therapy is not popular among academicians and private practitioners who prefer precise diagnosis and treatment with superior MDT regimens and for a longer duration. On the contrary, from a public health-care point of view, precise diagnosis and a longer treatment schedule are not cost effective and not feasible to be implemented in elimination programs. Hence, a fine balance needs to be maintained between achieving a cure for the patient and protecting the society at risk, and this review discusses the various limitations and opportunities of FD therapy with a note on the newer MDT regimens.
在实施多药联合疗法（MDT）后，麻风病被认为是一种可治愈的疾病。MDT已被证明是安全有效的，它通过将麻风病控制提升到根除的下一阶段，给全球和国家的麻风病防治形势带来了重大变化。自引入以来，治疗麻风病的MDT方案经历了几次变化，特别是在治疗持续时间方面。缩短治疗持续时间的优势需要与复发风险相权衡，并且在这方面存在许多争议。固定疗程（FD）疗法在更喜欢精确诊断和使用更优质MDT方案进行更长疗程治疗的学者和私人从业者中并不受欢迎。相反，从公共卫生保健的角度来看，精确诊断和更长的治疗方案不具有成本效益，并且在消除计划中实施也不可行。因此，需要在治愈患者和保护有风险的社会之间保持良好平衡，本综述讨论了FD疗法的各种局限性和机遇，并提及了更新的MDT方案。
