02057nas a2200385   4500000000100000008004100001260001300042653001200055653003100067653001100098653001100109653001200120653000900132653000900141653002500150653001500175653001300190653001700203100001600220700002200236700001200258700001400270700001500284700002500299700001400324700001700338700001800355700001300373245009300386856004100479300001100520490000700531520111900538022001401657       1989                            d  c1989 Sep10aAnimals10aDrug Resistance, Microbial10aFemale10aHumans10aleprosy10aMale10aMice10aMycobacterium leprae10aRecurrence10aRifampin10aTime Factors1 aGrosset J H1 aGuelpa-Lauras C C1 aBobin P1 aBrucker G1 aCartel J L1 aConstant-Desportes M1 aFlageul B1 aFrédéric M1 aGuillaume J C1 aMillan J00aStudy of 39 documented relapses of multibacillary leprosy after treatment with rifampin.  uhttp://ila.ilsl.br/pdfs/v57n3a02.pdf  a607-140 v573 a<p>Among 39 strains of Mycobacterium leprae isolated from patients with multibacillary leprosy who relapsed after treatment with rifampin (RMP), 22 strains were resistant to RMP and 17 were susceptible. All of the RMP-resistant strains were recovered from patients who had been treated with more than 50 doses of RMP, usually given as monotherapy. RMP-susceptible strains were recovered from only six patients who had received more than 50 doses of RMP, and from 11 patients who had received no more than seven doses. The median time to relapse after the beginning of RMP therapy was 9 years (range 1-12 years) among the patients harboring RMP-resistant strains of M. leprae, and the median time to relapse after discontinuation of RMP treatment was 7 years (range 1-11 years) among the patients harboring RMP-susceptible strains. These data suggest that monotherapy with more than a few doses of RMP can be responsible for the emergence of RMP-resistant strains of M. leprae, thus emphasizing the need to employ RMP only in combination with other effective drugs in the chemotherapy of multibacillary leprosy.</p>  a0148-916X