Leprosy-Insufficient Evidence for Monthly Multidrug Therapy-Reply.

In Reply We thank Adler et al for their insightful comments regarding our article and the treatment of lepromatous leprosy. As highlighted by these authors, the US National Hansen’s Disease Program (NHDP) has traditionally recommended treating multibacillary leprosy with daily rifampin, dapsone, and clofazimine for 24 months.

However, as the authors mention, there have been recent new recommendations for monthly, rather than daily, multidrug leprosy therapy. Some of these recommendations have originated from the NHDP itself, including at a 2023 NHDP webinar. The University of Missouri–Kansas City infectious disease clinic also received this guidance for monthly treatment from the NHDP. Specific considerations that went into the decision for monthly multidrug treatment with rifampin, moxifloxacin, and minocycline for the patient in our article were access to care and treatment adherence concerns.