Hansen's Disease (Leprosy)

Current and Future Pharmacotherapy and Treatment of Disease-related Immunologic Reactions

Davey P. Legendre, Pharm.D.; Christina A. Muzny, M.D.; Edwin Swiatlo, M.D., Ph.D.

Disclosures

Pharmacotherapy. 2012;32(1):27-37. 

In This Article

Fluoroquinolones

Although not considered primary therapy in most instances, fluoroquinolones, such as moxifloxacin and ofloxacin, remain an important option for treating Hansen's disease, especially in patients with intolerance, resistance, or clinical failure to primary therapy. Fluoroquinolones are active against M. leprae by inhibiting DNA gyrase and inhibiting DNA replication and transcription.[48] Agents, such as moxifloxacin, exhibit powerful bactericidal activity similar to that of rifampin, with one dose producing substantial kill. In one study, no viable organisms remained after 3 weeks of daily therapy.[49] Ofloxacin has substantial activity and is recommended as a single dose with other drugs for single-lesion disease, but due to a slightly increased failure rate compared with standard therapy, this regimen should be limited to countries with limited resources or operational difficulties.[50,51] Other agents in this class, such as ciprofloxacin, show little to no activity.[52] Fluoroquinolone resistance occurs primarily through mutations in gyrA but is not associated with mutations in gyrB.[53]

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