[27-30] In 2016, the WHO endorsed the use of an MDR-TB short course consisting of an initial phase of kanamycin, moxifloxacin, high-dose INH, ethionamide, clofazimine
, PZA and ethambutol.
Characteristics that did not meet the defined proportionality assumptions were sex, race, type of schema, cavities on X-ray, capreomycin resistance, presence of silicosis, hepatitis, smoking, diabetes, neoplasia, corticosteroid use, organ transplant, renal failure, ofloxacin use, pyrazinamide use, clofazimine
Patients were also advised complete sun protection as Clofazimine
induces hyperpigmentation but in spite of several reminders patients presented with complete Clofazimine
induced hyper pigmented face and over all hyper pigmentation of the body.
Antileprosy and antituberculosis treatment (rifampicin 600 mg/day, dapsone 100 mg/day, and clofazimine
100 mg/day) was initiated and was generally well tolerated, leading to a favorable response.
Alternative therapies include dapsone, sulfapyridine, methotrexate, clofazimine
, minocycline, colchicine, intravenous immunoglobulins and anti-TNF-a agents.5
* delamanid for the treatment of children and adolescents with multidrug-resistant tuberculosis (MDR-TB) and clofazimine
for children and adults with MDR-TB;
Other new options include pretomanid, and older repurposed drugs such as clofazimine
. The combination of bedaquiline, pretomanid and linezolid was recently shown to be very effective in the NIX-TB clinical trial, reinforcing the positive impact of research.
Nineteen chemicals were purchased from Sigma-Aldrich Company: cefoxitin (FOX), cefoperazone (CFP), cefmetazole (CMZ), cefepime (FEP), rifapentine (RPT), rifabutin (RBT), azithromycin (AZM), clarithromycin (CLR), roxithromycin (ROX), thioacetazone (THI), doxycycline (DOX), minocycline (MIN), tigecycline (TIG), meropenem (MEM), clofazimine
(CLO), sulfamethoxazole (SMZ), pasiniazid (PASI), linezolid (LNZ), and dapsone (DAP).
The isolates from these two towns (Nsawam and Amasaman) in addition to the reference strains were tested against eight selected antimicrobial agents, namely, amikacin, azithromycin, dapsone, ciprofloxacin, clofazimine
, ofloxacin, rifampicin, and streptomycin.
Final susceptibility results demonstrated resistance to isoniazid, rifampicin, rifabutin, clofazimine
, and streptomycin with sensitivity to ethambutol, pyrazinamide, amikacin, capreomycin, ciprofloxacin, cycloserine, and ethionamide.
A diagnosis of lepromatous leprosy was established and treatment with rifampicin (600mg/day), dapsone (100mg/day) and clofazimine
(100mg/48 hours) was started and prescribed during 2 years.
In the meantime, skin biopsy reported positive for acid-fast bacilli following which immediately multidrug therapy for leprosy comprising of dapsone (100 mg), rifampicin (600 mg stat), and clofazimine
(300 mg nightly) along with steroids (40 mg od) and thalidomide (300 mg nightly) was started.