01940nas a2200241   4500000000100000008004100001260001200042653001500054653001700069653002000086653001200106653002200118100001200140700001200152700001600164700001600180700001300196700001300209245007800222856007200300520131200372022001401684       2022                            d  c04/202210atratamento10aChemotherapy10aDrug Resistance10aleprosy10aMolecular Biology1 aAubry A1 aRosa SP1 aChauffour A1 aFletcher LM1 aCambau E1 aAvanzi C00aDrug resistance in leprosy: an update following 70 years of chemotherapy.  uhttps://www.sciencedirect.com/science/article/pii/S26669919220006653 a<p>Leprosy is one of the oldest infectious diseases, reported for more than 2,000 years. Leprosy elimination goal as a public health problem set by the World Health Organization, aiming for a global prevalence rate &lt;1 patient in a population of 10,000, was achieved in 2000 mainly thanks to the worldwide use of leprosy drugs starting in the 1980s and their access at no cost for patients since 1995. However, around 200,000 new cases are still reported each year, particularly in India, Brazil, and Indonesia. As with other bacteria of medical interest, antimicrobial resistance is observed in Mycobacterium leprae strains in several parts of the world, despite multidrug therapy being the recommended standard leprosy treatment to avoid resistance selection since 1982. Therefore, identifying and monitoring resistance is necessary. We provide an overview of the historical facts that led to the current drug resistance situation, the antibiotics effective against M. leprae, their mechanisms of action and resistance, and resistance detection methods. We also discuss therapeutic management of the resistant cases, new genes with potential roles in drug resistance and bacterial adaptation, new drugs under investigation, and the risk for resistance selection with the chemoprophylaxis measures.</p>
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