Negligible risk of inducing resistance in Mycobacterium tuberculosis with single-dose rifampicin as post-exposure prophylaxis for leprosy.

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TítuloNegligible risk of inducing resistance in Mycobacterium tuberculosis with single-dose rifampicin as post-exposure prophylaxis for leprosy.
Tipo de PublicaciónJournal Article
AutoresMieras L, Anthony R, van Brakel WH, Bratschi MW, Van Den Broek J, Cambau E, Cavaliero A, Kasang C, Perera G, Reichman L, Richardus JH, Saunderson P, Steinmann P, Yew WW
Abbrev. JournalInfect Dis Poverty
RevistaInfectious diseases of poverty
Año de Publicacion2016
Volume5
Issue1
Pagination46
Idioma de Publicacióneng
Palabras clave Chemoprophylaxis., Leprosy, LPEP, Mycobacterium tuberculosis, Post-exposure prophylaxis, Rifampicin resistance
Resumen

Post-exposure prophylaxis (PEP) for leprosy is administered as one single dose of rifampicin (SDR) to the contacts of newly diagnosed leprosy patients. SDR reduces the risk of developing leprosy among contacts by around 60 % in the first 2-3 years after receiving SDR. In countries where SDR is currently being implemented under routine programme conditions in defined areas, questions were raised by health authorities and professional bodies about the possible risk of inducing rifampicin resistance among the M. tuberculosis strains circulating in these areas. This issue has not been addressed in scientific literature to date. To produce an authoritative consensus statement about the risk that SDR would induce rifampicin-resistant tuberculosis, a meeting was convened with tuberculosis (TB) and leprosy experts. The experts carefully reviewed and discussed the available evidence regarding the mechanisms and risk factors for the development of (multi) drug-resistance in M. tuberculosis with a view to the special situation of the use of SDR as PEP for leprosy. They concluded that SDR given to contacts of leprosy patients, in the absence of symptoms of active TB, poses a negligible risk of generating resistance in M. tuberculosis in individuals and at the population level. Thus, the benefits of SDR prophylaxis in reducing the risk of developing leprosy in contacts of new leprosy patients far outweigh the risks of generating drug resistance in M. tuberculosis.

PubMed URL

http://www.ncbi.nlm.nih.gov/pubmed/27268059?dopt=Abstract

DOI10.1186/s40249-016-0140-y
Link to full texthttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897814/pdf/40249_2016_Article_140.pdf