Ofloxacin-Containing Multidrug Therapy in Ambulatory Leprosy Patients: A Case Series.

Abstract

BACKGROUND:

Standard dapsone and clofazimine-containing multidrug therapy (MDT) for leprosy is limited by drug tolerability, which poses treatment adherence barriers. Although ofloxacin-based regimens are promising alternatives, current efficacy and safety data are limited, particularly outside of endemic areas. We evaluated treatment outcomes in patients with leprosy receiving ofloxacin-containing MDT (OMDT) at our center.

METHODS:

We performed a retrospective chart review of patients treated for leprosy at our center over an 8-year period (2011-2019). Primary outcomes evaluated were clinical cure rate, occurrence of leprosy reactions, antibiotic-related adverse events, and treatment adherence. Analyses were descriptive; however, data were stratified by age, sex, spectrum of disease, region of origin, and treatment regimen, and odds ratios were reported to assess associations with adverse outcomes.

RESULTS:

Over the enrolment period, 26 patients were treated with OMDT (n = 19 multibacillary, n = 7 paucibacillary), and none were treated with clofazimine-based standard MDT. At the time of analysis, 23 patients (88%) had completed their course of treatment, and all were clinically cured, while 3 (12%) were still on treatment. Eighteen patients (69%) experienced either ENL (n = 7, 27%), type 1 reactions (n = 7, 27%), or both (n = 4, 15%). No patients stopped ofloxacin due to adverse drug effects, and there were no cases of allergic hypersensitivity, tendinopathy or rupture, or C. difficile colitis.

CONCLUSIONS:

We demonstrate a high cure rate and tolerability of OMDT in this small case series over an 8-year period, suggesting its viability as an alternative to standard clofazimine-containing MDT.

• Authors: Lena Faust, Michael Klowak, Cara MacRae, Swana Kopalakrishnan, Adrienne J Showler, Andrea K Boggild
• Journal: Journal of cutaneous medicine and surgery (J Cutan Med Surg) 2021 Jan-Feb Vol. 25 Issue 1 Pg. 45-52 ISSN: 1615-7109 [Electronic] United States
• PMID: 32869655 (Publication Type: Journal Article)

Chemical References

• Leprostatic Agents
• Dapsone
• Ofloxacin
• Minocycline
• Rifampin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Child, Preschool
• Dapsone (therapeutic use)
• Drug Therapy, Combination (adverse effects)
• Erythema Nodosum (chemically induced)
• Female
• Humans
• Leprostatic Agents (adverse effects, therapeutic use)
• Leprosy, Lepromatous (drug therapy)
• Leprosy, Paucibacillary (drug therapy)
• Male
• Medication Adherence
• Middle Aged
• Minocycline (therapeutic use)
• Ofloxacin (adverse effects, therapeutic use)
• Retrospective Studies
• Rifampin (therapeutic use)
• Treatment Outcome
• Young Adult