Résistance aux traitements contre la lèpre (maladie de Hansen)

• Historical Events in the treatment of Hansen’s disease (Leprosy).
  • 1943 – Paget reported promin treatment (sulphone)
  • 1949 – dapsone introduced
  • 1981 – MDT (Multi Drug Therapy) introduced
  • 1964 – Dapsone resistance reported
  • 1976 – Rifampicin resistance reported
  • 2005 – Quinolone resistance reported
  • 2007 – Cases of Resistance to MDT in 2007 reported
  • 2009 – The WHO  constructed guidelines for drug surveillance guidelines in leprosy

• In Malaysia:
  • dapsone resistance = 10% of treated cases (decreased from 75% in 1997 to 10% in 200. It can be explained because of use as monotherapy before the MDT Era)
  • clofazamine had similar ressitance rates to dapsone in 1997 but no more resistance reported since 2005
  • rifampicine had only partial resistance but it also disappeared from 2005 onwards.

Conclusion: in Malaysia, cases of resistance to treatment exist, but are a lot lower thanks to MDT.

Contributors

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

Ambrose D.  Drug Resistant Leprosy – What tales are my Mice telling me ?. Leprosy and other Mycobacteriosis – Status Update. 2014 (4) – 21st Regional Conference of Dermatology; Danang (Vietnam)