02497nas a2200361   4500000000100000008004100001653002200042653001200064653000900076653003100085653003000116653002600146100001300172700001400185700001800199700001500217700002000232700001300252700001600265700001300281700001300294700001500307700001700322700001700339700001600356700001100372245014300383856008800526300000700614490000600621520149400627022001402121       2016                            d10aChemoprophylaxis.10aleprosy10aLPEP10aMycobacterium tuberculosis10aPost-exposure prophylaxis10aRifampicin resistance1 aMieras L1 aAnthony R1 avan Brakel WH1 aBratschi M1 aVan Den Broek J1 aCambau E1 aCavaliero A1 aKasang C1 aPerera G1 aReichman L1 aRichardus JH1 aSaunderson P1 aSteinmann P1 aYew WW00aNegligible risk of inducing resistance in Mycobacterium tuberculosis with single-dose rifampicin as post-exposure prophylaxis for leprosy.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897814/pdf/40249_2016_Article_140.pdf  a460 v53 a<p>Post-exposure prophylaxis (PEP) for leprosy is administered as one single dose of rifampicin (SDR) to the contacts of newly diagnosed leprosy patients. SDR reduces the risk of developing leprosy among contacts by around 60&nbsp;% in the first 2-3 years after receiving SDR. In countries where SDR is currently being implemented under routine programme conditions in defined areas, questions were raised by health authorities and professional bodies about the possible risk of inducing rifampicin resistance among the M. tuberculosis strains circulating in these areas. This issue has not been addressed in scientific literature to date. To produce an authoritative consensus statement about the risk that SDR would induce rifampicin-resistant tuberculosis, a meeting was convened with tuberculosis (TB) and leprosy experts. The experts carefully reviewed and discussed the available evidence regarding the mechanisms and risk factors for the development of (multi) drug-resistance in M. tuberculosis with a view to the special situation of the use of SDR as PEP for leprosy. They concluded that SDR given to contacts of leprosy patients, in the absence of symptoms of active TB, poses a negligible risk of generating resistance in M. tuberculosis in individuals and at the population level. Thus, the benefits of SDR prophylaxis in reducing the risk of developing leprosy in contacts of new leprosy patients far outweigh the risks of generating drug resistance in M. tuberculosis.</p>
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