Retrospective analysis of prescriptions in the management of lepra reactions: Results of a single center study from tertiary hospital in Maharashtra
DOI:
https://doi.org/10.22159/ajpcr.2017.v10i5.17346Keywords:
Lepra reaction, Retrospective analysis, MaharashtraAbstract
Objective: To examine pattern of lepra reaction andmedicines used in the treatment of lepra reactions in a tertiary hospital.
Material methods: In this retrospective study, prescriptions of patients treated for the lepra reactions were reviewed to find out prevalence of type 1 and type 2 reactions and medicines used in the treatment of lepra reactions.
Results:A total of66 patients (male 59.1%; female 40.9%) with mean age of 36.6 (+13.1) years were included in the study. Multibacillary leprosy was present in 93.7% patients. A total of 39 (60%) patients had type 2 reaction whereas 26 (40%) had type 1 reaction. Mean number of medicines per patients was 7.5. Prednisolone was used in 62 (93.9%) patients with mean duration of 33.32 (+33.2) days whereas chloroquine was used in 52 (78.8%) patients for 36.6 (+27.9) days. Thalidomide was used in 25 (37.9%) patients. Analgesic and anti-inflammatory and anti-acidity drugs were used in 63 (95.4%) patients each whereas paracetamol was given to 41 (62.1%) patients. Antihistamine, antimicrobial agent and vitamins were given to 27 (40.9%), 27 (40.9%) and 35 (53.0%) patients respectively.
Conclusion:Lepra 2 reaction is more common than lepra 1 reaction. Prednisolone and chloroquine are the two most commonly used medicines in the treatment of lepra reaction. Similarly, thalidomide, older drug has emerged as common treatment for lepra reaction.
Downloads
References
Desikan KV. Elimination of leprosy & possibility of eradication – the Indian scenario. Indian J Med Res 2012;135:3-5
Vinod KV, Chandramohan R, Dutta TK, Rajesh NG, Basu D. Type 2 lepra reaction as a cause of pyrexia of unknown origin. J Physician Assoc India. 2012; 60:70-72
Kumar B. World Leprosy Day 2015: Renewing commitment for a leprosy free world!Indian J Med Res 2015;141:1-4
Kahawita IP, Walker SL, Lockwood DNJ. Leprosy type 1 reactions and erythema nodosumleprosum. An Bras Dermatol. 2008;83:75-82
Vijauakumaran P, Jesudasan K, Manimozhi N. Fixed-duration therapy (FDT) in multibacillary leprosy; efficacy and complications. Int J Lepr Other Mycobact Dis 1996;64:123-7
Raffe SF, Thapa M, Khadge S, Tamang K, Hagge D, Lockwood DNJ. Diagnosis and treatment of leprosy reactions in integrated services - The patients’ perspective in Nepal. PLoSNegl Trop Dis 2013; 7(3): e2089. doi:10.1371/journal.pntd.0002089
Treatment of lepra reaction. Available at http://apps.who.int/medicinedocs/en/d/Jh2988e/6.html#Jh2988e.6 accessed on 14th January 2017
HosahalliRajaiahYogeesh HR, Chankramath S, Yadalla HKK, Shariff S, Ramesh SB, Sreekantaiah SB. Type 2 lepra reaction (ENL) presenting with extensive cutaneous ulcerations. Our Dermatol Online. 2012; 3: 17-20
Pandhi D, Chhabra N. New insights in the pathogenesis of type 1 and type 2 lepra reaction. Indian J DermatolVenereolLeprol 2013;79:739-49
HNR, George R, Eapen EP, Pulimood SA, Gnanamuthu C, Jacob M, et al. A comparison of economic aspects of hospitalization versus ambulatory care in the management of neuritis occurring in lepra reaction. Int J Lepr Other Mycobact Dis 2004;72:448-56
Walker SL, Lockwood DNJ.Leprosy Type 1 (reversal) reactions and their management. Lepr Rev 2008; 79: 372–386
Sarita S, Muhammed K, Najeeba R, Rajan GN, Anza K, Binitha MP, Aparna G. A study on histological features of lepra reactions in patients attending the dermatology department of the government medical college, Calicut, Kerala, India. Lepr Rev 2013; 84:51–64
Roy K, Sil A, Das NK, Bandopadhyay D. Effectiveness and safety of clofazimine and pentoxifylline in type 2 lepra reaction: a double-blind, randomized, controlled study. Int J Dermatol 2015;54:1325-32
Girdhar BK. Immunopharmacology of drugs used in leprosy reactions. Indian J DermatolVenerolLeprol 1990;56:354-63
Use of thalidomide in leprosy. http://www.who.int/lep/research/thalidomide/en/ Accessed on 21st January 2017
Pai VV. Role of clofazimine in management of reactions in leprosy: A brief overview. Indian J Drugs Dermatol 2015;1:12-5
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.