Ans. c (Rifampicin + Dapsone + Clofazimine); (Ref. Park PSM 22nd/pg. 296)Recommended regimens of chemotherapy for Leprosy in adultsFORM OF LEPROSYMORE INTENSIVE REGIMENWHO RECOMMENDED REGIMENLepromatous(multibacillary)Rifampin (600 mg/d) for 3 years plus dapsone (100 mg/d) indefinitelyDapsone (100 mg/d self-administered) plus clofazimine (300 mg once monthly for 1-2 yrs supervised; and 50 mg/d self-adm); and rifampin (600 mg once monthly undersupervision). Note: Clofazimine is unacceptable owing to discoloration of the skin, its replacement by 250-375 mg self-adm daily ethionamide or propionamide has been suggested.Tuberculoid (paucibacillary)Dapsone (100 mg/d) for 5 years Dapsone (100 mg/d, unsupervised) plus rifampin(600 mg/month, supervised) for 6 months.# ******** Duration of Rx for Multibacillary leprosy = MB blisterpacks for 12 months, within 18 months.# ******* Duration of Rx for Paucibacillary leprosy = PB blisterpacks for 6 months, within 9 months# ******Rifampin is considered the most active agent for the treatment of leprosy.# *****Dapsone inhibits bacterial folic acid synthesis & is now considered the second most active drug (after rifampin) in the treatment of leprosy.# ****Clofazimine is useful in treating dapsone-resistant leprosy and may lessen the severity of ENL.# ***Thalidomide is now approved by the FDA for treatment of ENL. This drug is sedating and extremely teratogenic and should never be taken by anyone who is or may become pregnant.# **Ethionamide with rifampin (600 mg/d) is used to treat dapsone-resistant leprosy for who cannot accept the skin- pigmentation of clofazimine.# The newer macrolide antibiotics (particularly clarithromycin), minocycline (a long-acting tetracycline), and a number of fluoroquinolones (including ofloxacin, sparfloxacin, and pefloxacin) have shown promising bactericidal activity against M. leprae. Ofloxacin and minocycline are being investigated with rifampin in short-course regimens for lepromatous disease.