## WHO MDT Regimen for Lepromatous Leprosy ### Standard 12-Month Regimen **Key Point:** The WHO MDT for lepromatous leprosy (LL) consists of three drugs given in a fixed combination for 12 months. | Drug | Dose | Frequency | Role | | --- | --- | --- | --- | | Rifampicin | 600 mg | Monthly supervised | Bactericidal; most potent | | Clofazimine | 300 mg (monthly) + 100 mg (daily) | Monthly + daily | Bacteriostatic; anti-inflammatory | | Dapsone | 100 mg | Daily | Bacteriostatic; synergistic | ### Why Streptomycin is NOT Part of Standard MDT **High-Yield:** Streptomycin is **NOT** a component of WHO MDT for leprosy (LL or BL). It was used historically in older regimens but has been replaced by the three-drug combination above because: - Resistance develops rapidly when used alone - Ototoxicity and nephrotoxicity limit its use - Better alternatives (rifampicin, clofazimine, dapsone) are available **Clinical Pearl:** Streptomycin may be used in drug-resistant TB-leprosy co-infection cases, but NOT as part of standard leprosy MDT. ### Mnemonic for LL MDT **"RCD-LL"** = **R**ifampicin, **C**lofazimine, **D**apsone for **L**epromatous **L**eprosy ### Duration and Supervised Doses - **12 months** total duration - Minimum **12 supervised doses** (monthly) - Daily self-administered doses at home - Compliance crucial for cure and preventing drug resistance
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