Multi-drug therapy (MDT) MDT treatment is provided in blister packs, each containing four weeks' treatment. Specific blister packs are available for multibacillary (MB) and paucibacillary (PB) leprosy as well for adults and children. Standard adult treatment regimen for MB leprosy: Rifampicin: 600 mg once a month Clofazimine: 300 mg once a month, and 50 mg daily Dapsone: 100 mg daily Duration: 12 months (12 blister packs) Standard adult treatment regimen for PB leprosy: Rifampicin: 600 mg once a month Dapsone: 100 mg daily Duration: six months (six blister packs) Standard child (ages 10 - 14) treatment regimen for MB leprosy: Rifampicin: 450 mg once a month Clofazimine: 150 mg once a month, and 50 mg every other day Dapsone: 50 mg daily Duration: 12 months (12 blister packs) Standard child (ages 10 - 14) treatment regimen for PB leprosy: Rifampicin: 450 mg once a month Dapsone: 50 mg daily Rifampicin is a potent bactericidal for M. leprae but should always be given in combination with other antileprotics, since a single-step mutation can confer resistance. Dapsone is bacteriostatic. It commonly causes mild haemolysis and rarely anaemia. Clofazimine is a red, fat-soluble crystalline dye, weakly bactericidal for M. leprae. Skin discoloration (red to purple-black) and ichthyosis are troublesome side-effects, paicularly on pale skins. New bactericidal drugs against M. leprae have been identified, notably fluoroquinolones (pefloxacin and ofloxacin). Minocycline and clarithromycin may also be used. These agents are now established second-line drugs. Minocycline causes a grey pigmentation of skin lesions. Ref Harrison20th edition pg 1078