In the WHO classification of leprosy for treatment purposes, multibacillary (MB) leprosy is defined as having more than five skin lesions and/or positive slit-skin smear. Which regimen constitutes standard MB-MDT (multi-drug therapy) as per current WHO guidelines?

• A Rifampicin + Dapsone for 12 months
• B Rifampicin + Clofazimine + Dapsone for 24 months
• C Rifampicin + Ofloxacin + Minocycline (ROM) for 24 months
• D Rifampicin + Clofazimine + Dapsone for 12 months ✓

Explanation

WHO standard MB-MDT consists of monthly supervised rifampicin 600 mg + clofazimine 300 mg, plus daily self-administered clofazimine 50 mg + dapsone 100 mg, for 12 months (currently recommended duration, changed from the previous 24-month course). PB-MDT (paucibacillary) uses rifampicin + dapsone for 6 months. ROM therapy (rifampicin + ofloxacin + minocycline) is used as a single-dose or 6-month alternative for single-lesion PB leprosy, not for MB leprosy.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

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