Leprosy-Insufficient Evidence for Monthly Multidrug Therapy.

To the Editor In the recent case report by Poondru et al, a patient with lepromatous leprosy was treated with monthly multidrug antibiotic therapy (rifampin, moxifloxacin, and minocycline) following consultation with the US National Hansen’s Disease Program (NHDP). The patient also initiated treatment with methotrexate and prednisone “to reduce the risk of erythema nodosum leprosum.”¹ On behalf of several US leprosy experts, we are concerned about the lack of evidence supporting these treatment recommendations, which diverge from published NHDP guidelines recommending daily antibiotic therapy with the possible exception of monthly rifampin.