01825nas a2200217   4500000000100000008004100001260001300042653003000055653002100085653001100106653002300117653001200140653002500152653003300177100001400210245004800224300001100272490000700283520130300290022001401593       2003                            d  c2003 Jan10aDrug Therapy, Combination10aErythema Nodosum10aHumans10aLeprostatic Agents10aleprosy10aLeprosy, lepromatous10aPractice Guidelines as Topic1 aFlageul B00a[Current guidelines for leprosy treatment].  a357-610 v963 a<p>During the last 20 years, the global leprosy situation has strikingly changed with a decrease of cases from 12 millions estimated cases in 1982 to 600,000 registered cases in the year 2000. However, during the past 15 years, about 700,000 new cases are still detected annually. The systematic use of multidrug therapy (MDT), as recommended by a WHO Study Group in 1982, has proven its efficacy as assessed by the low reported relapse rate (less than 1% per year). The initial PCT schedule has been modified several times, but this PCT remains the recommended chemotherapy for the great majority of patients. New potent antibacillary drugs (ofloxacin, minocycline, clarithromycine) have been discovered; however, their current use is limited and should remain limited until under way trials could confirm their efficacy. With the use of PCT, the frequency of immunologically mediated reactional states have changed. The occurrence of reversal reaction, (type 1 reaction) has significantly increased while that of erythema nodosum leprosum (ENL, type 2) appeared less common. Because of the high risk of neurological permanent damage, reversal reaction needs to be diagnosed and treated as soon as possible. Here in, the current antibacillary and antireactionnal treatments are being reviewed.</p>  a0037-9085