## Classification and MDT Regimen Selection **Key Point:** The patient presents with lepromatous leprosy (LL) — evidenced by high bacillary load (4+ on slit-skin smear), widespread distribution, and nodular lesions. This is the most severe form requiring multibacillary (MB) therapy. ## WHO-Recommended MDT for Lepromatous Leprosy | Component | Dosage | Duration | Frequency | |-----------|--------|----------|----------| | Rifampicin | 600 mg | 12 months | Monthly supervised | | Dapsone | 100 mg | 12 months | Daily unsupervised | | Clofazimine | 300 mg (monthly) + 50 mg (daily) | 12 months | Mixed | **High-Yield:** The standard WHO-MDT for **multibacillary leprosy** (which includes LL, BL, and BB types) is **RDC (Rifampicin-Dapsone-Clofazimine) for 12 months**. This is the most commonly used regimen in India and is the gold standard. ## Why This Regimen? 1. **Rifampicin** — Most potent anti-leprosy drug; kills 99.9% of bacilli in first dose; given monthly supervised. 2. **Dapsone** — Bacteriostatic; prevents resistance; given daily unsupervised. 3. **Clofazimine** — Slow-acting; prevents resistance to rifampicin and dapsone; given both monthly and daily. **Clinical Pearl:** Clofazimine causes brown-black discoloration of skin and body fluids — counsel patients beforehand to improve compliance. **Mnemonic:** **RDC-12** = Rifampicin, Dapsone, Clofazimine for 12 months (multibacillary leprosy). [cite:Park 26e Ch 9]
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.