Trials of daily, long-term minocycline and rifampin or clarithromycin and rifampin in the treatment of borderline lepromatous and lepromatous leprosy

Daily, long-term treatment with minocycline 100 mg and rifampin 600 mg was initiated in 24 previously untreated borderline lepromatous (BL) and leprom atous (LL) patients for a total of 646 patient-months, averaging 26.9 month s per patient. The same regimen was started in 12 BL and LL patients having a bacteriologic relapse for a total of 379 patient-months, averaging 32.5 months per patient, and in 12 patients judged to be at high risk for relaps e for a total of 354 patient-months, averaging 29.5 months per patient. Dai ly, long-term treatment with clarithromycin 500 mg and rifampin 600 mg was initiated in 8 previously untreated BL and LL patients for a total of 174 p atient-months, averaging 21.8 months per patient. The results in these 56 p atients were compared to those obtained in 34 previously untreated BL and L L patients who were treated concurrently receiving daily, long-term dapsone 100 mg and rifampin 600 mg. No evidence of dangerous drug reactions or bon e marrow, kidney or liver toxicity was seen in any of these five patient gr oups. Drug intolerance in 10 of the 90 patients studied necessitated discon tinuing the chosen regimen, 4 from rifampin, 3 from dapsone, 2 from minocyc line and 1 of undetermined attribution. The use of either minocycline or cl arithromycin in conjunction with rifampin appears to pose no great risk whe n used long term.