DOCSLIB.ORG

Leprosy Post-Exposure Prophylaxis with Single-Dose Rifampicin (LPEP): an International Feasibility Programme

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Leprosy Post-Exposure Prophylaxis with Single-Dose Rifampicin (LPEP): an International Feasibility Programme Articles Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme Jan Hendrik Richardus, Anuj Tiwari, Tanja Barth-Jaeggi, Mohammad A Arif, Nand Lal Banstola, Rabindra Baskota, David Blaney, David J Blok, Marc Bonenberger, Teky Budiawan, Arielle Cavaliero, Zaahira Gani, Helena Greter, Eliane Ignotti, Deusdedit V Kamara, Christa Kasang, Pratap R Manglani, Liesbeth Mieras, Blasdus F Njako, Tiara Pakasi, Basu Dev Pandey, Paul Saunderson, Rajbir Singh, W Cairns S Smith, René Stäheli, Nayani D Suriyarachchi, Aye Tin Maung, Tin Shwe, Jan van Berkel, Wim H van Brakel, Bart Vander Plaetse, Marcos Virmond, Millawage S D Wijesinghe, Ann Aerts, Peter Steinmann Summary Background Innovative approaches are required for leprosy control to reduce cases and curb transmission of Lancet Glob Health 2020 Mycobacterium leprae. Early case detection, contact screening, and chemoprophylaxis are the most promising tools. Published Online We aimed to generate evidence on the feasibility of integrating contact tracing and administration of single-dose October 29, 2020 rifampicin (SDR) into routine leprosy control activities. https://doi.org/10.1016/ S2214-109X(20)30396-X Erasmus MC, University Methods The leprosy post-exposure prophylaxis (LPEP) programme was an international, multicentre feasibility Medical Center Rotterdam, study implemented within the leprosy control programmes of Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka, Rotterdam, Netherlands and Tanzania. LPEP explored the feasibility of combining three key interventions: systematically tracing contacts of (Prof J H Richardus PhD, individuals newly diagnosed with leprosy; screening the traced contacts for leprosy; and administering SDR to eligible A Tiwari PhD, D J Blok PhD); Swiss Tropical and Public contacts. Outcomes were assessed in terms of number of contacts traced, screened, and SDR administration rates. Health Institute, Basel, Switzerland Findings Between Jan 1, 2015, and Aug 1, 2019, LPEP enrolled 9170 index patients and listed 179 769 contacts, of (T Barth-Jaeggi PhD, whom 174 782 (97·2%) were successfully traced and screened. Of those screened, 22 854 (13·1%) were excluded from H Greter PhD, P Steinmann PhD); University of Basel, Basel, SDR mainly because of health reasons and age. Among those excluded, 810 were confirmed as new patients (46 per Switzerland (T Barth-Jaeggi, 10 000 contacts screened). Among the eligible screened contacts, 1182 (0·7%) refused prophylactic treatment with H Greter, P Steinmann); NLR, SDR. Overall, SDR was administered to 151 928 (86·9%) screened contacts. No serious adverse events were reported. New Delhi, India (M A Arif MD, P R Manglani MD); NLR, Kathmandu, Nepal Interpretation Post-exposure prophylaxis with SDR is safe; can be integrated into different leprosy control programmes (N L Banstola MBA); Ministry of with minimal additional efforts once contact tracing has been established; and is generally well accepted by index Health and Population of patients, their contacts, and health-care workers. The programme has also invigorated local leprosy control through Nepal, Kathmandu, Nepal the availability of a prophylactic intervention; therefore, we recommend rolling out SDR in all settings where contact (R Baskota MD, B D Pandey PhD); Centers for Disease Control and tracing and screening have been established. Prevention, Atlanta, GA, USA (D Blaney MD); FAIRMED, Bern, Funding Novartis Foundation. Switzerland (M Bonenberger PhD, R Stäheli MSc, Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. B Vander Plaetse MD); NLR, Jakarta, Indonesia Introduction Strategy 2016–20 identified early case detection and (T Budiawan MD); Novartis Foundation, Basel, Switzerland Leprosy is a chronic infectious disease caused by targeted case finding among high-risk groups as key (A Cavaliero MPH, Z Gani MSc, 4 Mycobacterium leprae. The clinical manifestations are strategic operational components. Although both early A Aerts MD); Universidade do largely confined to the skin, peripheral nervous system, case detection and targeted case finding can make an Estado de Mato Grosso, eyes, and upper respiratory tract. M leprae predominantly impact, additional interventions are needed to interrupt Cáceres, Brazil (Prof E Ignotti PhD); National affects peripheral nerves and immunologically mediated transmission. No leprosy-specific immuno prophylactic Tuberculosis and Leprosy reactions can cause nerve damage in the face, arms, and intervention is available. Although BCG vaccination Programme, Dodoma, Tanzania legs, often resulting in disability, which in turn can lead confers some level of protection,5 no vaccine on the (D V Kamara MD); German to stigma and social exclusion. Over the past decade, market specifically targets M leprae.6 The most effective Leprosy and Tuberculosis Relief Association, Würzburg, the annual number of new leprosy cases reported to approach to reducing the risk of developing leprosy Germany (C Kasang PhD); NLR, WHO has plateaued at slightly more than 200 000 patients, among individuals exposed to M leprae over extended Amsterdam, Netherlands from nearly 150 countries.1 Leprosy is a neglected disease periods is chemoprophylaxis, usually given to close (L Mieras MD, J van Berkel MA, with poor awareness among both the public and medical contacts of individuals who have been diagnosed with W H van Brakel PhD); German 7–9 Leprosy and Tuberculosis Relief practitioners. Innovation is needed to enhance the leprosy within the past 3 months. Association, Dar es Salaam, effectiveness of leprosy control by improving early case The idea of chemoprophylaxis in leprosy is not Tanzania (B F Njako MD); detection and reducing the risk of infection and disease new. In the 1960s and 1970s, trials were done in India Ministry of Health of the among those most at risk.2 The ultimate goal is to reduce and Uganda with dapsone administered as chemo- Republic of Indonesia, Jakarta, 10–14 Indonesia (T Pakasi MA); morbidity and to interrupt transmission of M leprae prophylaxis, subsequently followed by trials with American Leprosy Missions, between humans.3 Consequently, WHO’s Global Leprosy acedapsone in India.15,16 A meta-analysis indicated an www.thelancet.com/lancetgh Published online October 29, 2020 https://doi.org/10.1016/S2214-109X(20)30396-X 1 Articles Greenville, SC, USA (P Saunderson PhD); German Research in context Leprosy and Tuberculosis Relief Association, New Delhi, India Evidence before this study leprosy and tuberculosis have been ruled out, and in the absence (R Singh MD); University of The evidence for this international feasibility programme was of other contraindications. Aberdeen, Aberdeen, UK summarised by WHO as part of their guideline development (Prof W C S Smith PhD); Added value of this study process for leprosy, published in 2018. These evidence-based FAIRMED, Colombo, Sri Lanka This large-scale feasibility study in seven leprosy-endemic recommendations used guideline development methods based (N D Suriyarachchi MD); countries provides evidence that post-exposure prophylaxis American Leprosy Missions, on the Grading of Recommendations Assessment, Development with SDR is safe; can be integrated into different leprosy control Yangon, Myanmar and Evaluation (GRADE) approach. GRADE includes an (A Tin Maung MD, T Shwe MD); programmes with minimal additional efforts once contact assessment of quality of evidence (high, moderate, low, or very Instituto Lauro de Souza Lima tracing has been established; and is generally well accepted by low), consideration of the overall balance of benefits to harms & UNINOVE, Bauru, Brazil index patients, their contacts, and health-care workers. The (Prof M Virmond PhD); and (at individual and population levels), patient or health worker programme has also been shown to invigorate local leprosy Anti-Leprosy Campaign, values and preferences, resource use, effects on equity, cost– Colombo, Sri Lanka control through the availability of a prophylactic intervention. (M S D Wijesinghe MD) effectiveness, and consideration of feasibility and effectiveness across various settings, including resource-limited settings and Correspondence to: Implications of all the available evidence Prof Jan Hendrik Richardus, those in which access to laboratory infrastructure and Implementation of post-exposure prophylaxis with SDR should Department of Public Health, specialised tests is poor. The quality of evidence for post- be integrated in all leprosy-endemic countries as part of their Erasmus MC, University Medical exposure prophylaxis with single-dose rifampicin (SDR) in routine leprosy control programme. In fact, India, Indonesia, Center Rotterdam, 3000CA leprosy was considered moderate. The most authoritative study Rotterdam, Netherlands and Nepal have already started this integration at a local scale, [email protected] was a large single-centre, double-blind, cluster-randomised, and are planning national roll-out as resources permit. Further placebo-controlled trial to establish the preventive efficacy of research should focus on the optimal number of contacts to be SDR as post-exposure chemoprophylaxis in leprosy. In this trial, included, which probably depends on the local epidemiological SDR given to contacts of individuals with newly diagnosed situation (eg, endemicity level and ratio of multibacillary to leprosy resulted in an overall reduction in incidence of leprosy of paucibacillary patients), household
Load more

Recommended publications
  • Infant Antibiotic Exposure Search EMBASE 1. Exp Antibiotic Agent/ 2
    Infant Antibiotic Exposure Search EMBASE 1. exp antibiotic agent/ 2. (Acedapsone or Alamethicin or Amdinocillin or Amdinocillin Pivoxil or Amikacin or Aminosalicylic Acid or Amoxicillin or Amoxicillin-Potassium Clavulanate Combination or Amphotericin B or Ampicillin or Anisomycin or Antimycin A or Arsphenamine or Aurodox or Azithromycin or Azlocillin or Aztreonam or Bacitracin or Bacteriocins or Bambermycins or beta-Lactams or Bongkrekic Acid or Brefeldin A or Butirosin Sulfate or Calcimycin or Candicidin or Capreomycin or Carbenicillin or Carfecillin or Cefaclor or Cefadroxil or Cefamandole or Cefatrizine or Cefazolin or Cefixime or Cefmenoxime or Cefmetazole or Cefonicid or Cefoperazone or Cefotaxime or Cefotetan or Cefotiam or Cefoxitin or Cefsulodin or Ceftazidime or Ceftizoxime or Ceftriaxone or Cefuroxime or Cephacetrile or Cephalexin or Cephaloglycin or Cephaloridine or Cephalosporins or Cephalothin or Cephamycins or Cephapirin or Cephradine or Chloramphenicol or Chlortetracycline or Ciprofloxacin or Citrinin or Clarithromycin or Clavulanic Acid or Clavulanic Acids or clindamycin or Clofazimine or Cloxacillin or Colistin or Cyclacillin or Cycloserine or Dactinomycin or Dapsone or Daptomycin or Demeclocycline or Diarylquinolines or Dibekacin or Dicloxacillin or Dihydrostreptomycin Sulfate or Diketopiperazines or Distamycins or Doxycycline or Echinomycin or Edeine or Enoxacin or Enviomycin or Erythromycin or Erythromycin Estolate or Erythromycin Ethylsuccinate or Ethambutol or Ethionamide or Filipin or Floxacillin or Fluoroquinolones
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2010/0304998 A1 Sem (43) Pub
    US 20100304998A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2010/0304998 A1 Sem (43) Pub. Date: Dec. 2, 2010 (54) CHEMICAL PROTEOMIC ASSAY FOR Related U.S. Application Data OPTIMIZING DRUG BINDING TO TARGET (60) Provisional application No. 61/217,585, filed on Jun. PROTEINS 2, 2009. (75) Inventor: Daniel S. Sem, New Berlin, WI Publication Classification (US) (51) Int. C. GOIN 33/545 (2006.01) Correspondence Address: GOIN 27/26 (2006.01) ANDRUS, SCEALES, STARKE & SAWALL, LLP C40B 30/04 (2006.01) 100 EAST WISCONSINAVENUE, SUITE 1100 (52) U.S. Cl. ............... 506/9: 436/531; 204/456; 435/7.1 MILWAUKEE, WI 53202 (US) (57) ABSTRACT (73) Assignee: MARQUETTE UNIVERSITY, Disclosed herein are methods related to drug development. Milwaukee, WI (US) The methods typically include steps whereby an existing drug is modified to obtain a derivative form or whereby an analog (21) Appl. No.: 12/792,398 of an existing drug is identified in order to obtain a new therapeutic agent that preferably has a higher efficacy and (22) Filed: Jun. 2, 2010 fewer side effects than the existing drug. Patent Application Publication Dec. 2, 2010 Sheet 1 of 22 US 2010/0304998 A1 augavpop, Patent Application Publication Dec. 2, 2010 Sheet 2 of 22 US 2010/0304998 A1 g Patent Application Publication Dec. 2, 2010 Sheet 3 of 22 US 2010/0304998 A1 Patent Application Publication Dec. 2, 2010 Sheet 4 of 22 US 2010/0304998 A1 tg & Patent Application Publication Dec. 2, 2010 Sheet 5 of 22 US 2010/0304998 A1 Patent Application Publication Dec.
    [Show full text]
  • Lääkeaineiden Yleisnimet (INN-Nimet) 21.6.2021
    Lääkealan turvallisuus- ja kehittämiskeskus Säkerhets- och utvecklingscentret för läkemedelsområdet Finnish Medicines Agency Lääkeaineiden yleisnimet (INN-nimet) 21.6.
    [Show full text]
  • Customs Tariff - Schedule
    CUSTOMS TARIFF - SCHEDULE 99 - i Chapter 99 SPECIAL CLASSIFICATION PROVISIONS - COMMERCIAL Notes. 1. The provisions of this Chapter are not subject to the rule of specificity in General Interpretative Rule 3 (a). 2. Goods which may be classified under the provisions of Chapter 99, if also eligible for classification under the provisions of Chapter 98, shall be classified in Chapter 98. 3. Goods may be classified under a tariff item in this Chapter and be entitled to the Most-Favoured-Nation Tariff or a preferential tariff rate of customs duty under this Chapter that applies to those goods according to the tariff treatment applicable to their country of origin only after classification under a tariff item in Chapters 1 to 97 has been determined and the conditions of any Chapter 99 provision and any applicable regulations or orders in relation thereto have been met. 4. The words and expressions used in this Chapter have the same meaning as in Chapters 1 to 97. Issued January 1, 2019 99 - 1 CUSTOMS TARIFF - SCHEDULE Tariff Unit of MFN Applicable SS Description of Goods Item Meas. Tariff Preferential Tariffs 9901.00.00 Articles and materials for use in the manufacture or repair of the Free CCCT, LDCT, GPT, UST, following to be employed in commercial fishing or the commercial MT, MUST, CIAT, CT, harvesting of marine plants: CRT, IT, NT, SLT, PT, COLT, JT, PAT, HNT, Artificial bait; KRT, CEUT, UAT, CPTPT: Free Carapace measures; Cordage, fishing lines (including marlines), rope and twine, of a circumference not exceeding 38 mm; Devices for keeping nets open; Fish hooks; Fishing nets and netting; Jiggers; Line floats; Lobster traps; Lures; Marker buoys of any material excluding wood; Net floats; Scallop drag nets; Spat collectors and collector holders; Swivels.
    [Show full text]
  • Federal Register / Vol. 60, No. 80 / Wednesday, April 26, 1995 / Notices DIX to the HTSUS—Continued
    20558 Federal Register / Vol. 60, No. 80 / Wednesday, April 26, 1995 / Notices DEPARMENT OF THE TREASURY Services, U.S. Customs Service, 1301 TABLE 1.ÐPHARMACEUTICAL APPEN- Constitution Avenue NW, Washington, DIX TO THE HTSUSÐContinued Customs Service D.C. 20229 at (202) 927±1060. CAS No. Pharmaceutical [T.D. 95±33] Dated: April 14, 1995. 52±78±8 ..................... NORETHANDROLONE. A. W. Tennant, 52±86±8 ..................... HALOPERIDOL. Pharmaceutical Tables 1 and 3 of the Director, Office of Laboratories and Scientific 52±88±0 ..................... ATROPINE METHONITRATE. HTSUS 52±90±4 ..................... CYSTEINE. Services. 53±03±2 ..................... PREDNISONE. 53±06±5 ..................... CORTISONE. AGENCY: Customs Service, Department TABLE 1.ÐPHARMACEUTICAL 53±10±1 ..................... HYDROXYDIONE SODIUM SUCCI- of the Treasury. NATE. APPENDIX TO THE HTSUS 53±16±7 ..................... ESTRONE. ACTION: Listing of the products found in 53±18±9 ..................... BIETASERPINE. Table 1 and Table 3 of the CAS No. Pharmaceutical 53±19±0 ..................... MITOTANE. 53±31±6 ..................... MEDIBAZINE. Pharmaceutical Appendix to the N/A ............................. ACTAGARDIN. 53±33±8 ..................... PARAMETHASONE. Harmonized Tariff Schedule of the N/A ............................. ARDACIN. 53±34±9 ..................... FLUPREDNISOLONE. N/A ............................. BICIROMAB. 53±39±4 ..................... OXANDROLONE. United States of America in Chemical N/A ............................. CELUCLORAL. 53±43±0
    [Show full text]
  • Recent Advances in Diagnos-Tic Techniques and New Hope
    Prasad PVS, et al., J Clin Dermatol Ther 2017, 4: 027 DOI: 10.24966/CDT-8771/100027 HSOA Journal of Clinical Dermatology and Therapy Review Article hurdles. In India the National Leprosy Control Program (NLCP) has been in vogue since 1955. The annual new case detection rate in In- Recent Advances in Diagnos- dia was estimated as 9.73 per 100,000 population in 2015 [2]. With continuous implementation of elimination strategies in India almost tic Techniques and New Hope thirty-three states/ union territories have achieved the level of leprosy elimination i.e., Prevalence Rate (PR) less than one case per ten thou- Towards Leprosy Elimination sand population. However, some rural areas at district level, still form in the Post Elimination Era the pockets of endemic regions with higher prevalence rates [3]. India Prasad PVS*, Kaviarasan PK, Kannambal K, Poorana B and alone accounted for 58.85% of the global leprosy burden [4]. Accord- Abinaya R ing to September 2016 statistics, there are 102,178 cases in India. However, there is still an occurrence of considerable number of new Department of Dermatology Venereology & Leprosy,, Annamalai Universi- cases in India, indicating an ongoing transmission, with an Annual ty, Tamil Nadu, India New Case Detection Rate (ANCDR) of 9.98/100,000 population [4]. The diagnosis of leprosy is a challenge as there are no gold stan- dard methods to differentiate between infection and disease. Leprosy is also an endemic disease in developing countries, where detection rates show only a slight trend toward a decrease in the disease prev- alence. It is accepted that transmission occurs from human to human through the upper airways, although intermediate hosts like armadil- Abstract los may play a role in certain countries like United States.
    [Show full text]
  • WATBCP-WA-Leprosy-Guideline.Pdf
    Guidelines for the Diagnosis, Management and Prevention of Leprosy February 2019 Contents Chapter 1 9 1.0 Introduction 9 References 11 Chapter 2 Epidemiology 12 2.1 Global epidemiology 12 2.2 National epidemiology 13 2.3 Western Australia epidemiology 14 References 16 Chapter 3 Global Considerations 17 References 18 Chapter 4 Case definition 19 References 21 Chapter 5 Diagnosis of Leprosy 22 5.1 Clinical diagnosis 22 5.1.1 Presentation 22 5.1.2 Skin examination 23 5.1.3 Nerve palpation 24 5.1.4 Assessment of nerve function 25 5.1.5 Pain assessment 29 5.1.6 Eye Examination 30 5.1.7 Leprosy in Children 32 5.2 Laboratory Diagnosis 33 5.2.1 Introduction 33 5.2.2 Slit skin smears 33 5.2.3 Skin biopsy 35 5.2.4 Nerve biopsy and fine needle aspiration. 36 5.2.5 Molecular testing 37 5.2.6 Susceptibility testing 37 5.2.7 Quality control 39 5.2.8 Laboratory notification of results 39 5.3 Other diagnostic tools 39 5.3.1 Nerve conduction studies 39 5.3.2 Imaging 39 5.4 Disease Classification and Assessment 40 5.4.1 Introduction 40 Page 2 of 150 5.4.2 Ridley-Jopling classification 42 5.4.3 WHO Classification 42 5.4.4 NLEP Classification 42 5.4.5 Disability Grading 43 5.4.6 Case notification 45 5.4.7 Functional assessment 45 References 47 Chapter 6 Medical Treatment of Leprosy 50 6.1 Introduction 50 6.2 Principles of drug therapy for leprosy 51 6.3 Pre-treatment investigations and documentation 51 6.4 Treatment planning 51 6.5 Treatment Regimens 52 6.5.1 Patient monitoring while receiving leprosy treatment 53 6.5.2 Treatment completion 55 6.5.3 Follow
    [Show full text]
  • And Chemo-Prophylaxis
    Research and Reports in Tropical Medicine Dovepress open access to scientific and medical research Open Access Full Text Article REVIEW The State of Affairs in Post-Exposure Leprosy Prevention: A Descriptive Meta-Analysis on Immuno- and Chemo-Prophylaxis This article was published in the following Dove Press journal: Research and Reports in Tropical Medicine Anne Schoenmakers1 Objective: Annually, over 200,000 people are diagnosed with leprosy, also called Hansen’s Liesbeth Mieras 1 disease. This number has been relatively stable over the past years. Progress has been made Te k y B u d i aw a n 2 in the fields of chemoprophylaxis and immunoprophylaxis to prevent leprosy, with a primary Wim H van Brakel 1 focus on close contacts of patients. In this descriptive meta-analysis, we summarize the evidence and identify knowledge gaps regarding post-exposure prophylaxis against leprosy. 1 NLR, Amsterdam, The Netherlands; Methods: A systematic literature search according to the Preferred Reporting Items for 2NLR, Jakarta, Indonesia Systematic Reviews and Meta-Analyses (PRISMA) methodology was conducted by search- ing the medical scientific databases Cochrane, Embase, Pubmed/MEDLINE, Research Gate, Scopus and Web of Science on Jan. 22, 2020, using a combination of synonyms for index terms in four languages: “leprosy” and “population” or “contacts” and “prevention” or “prophylaxis.” Subsequently, Infolep.org and Google Scholar were searched and the "snow- ball method" was used to retrieve other potentially relevant literature. The found articles were screened for eligibility using predetermined inclusion and exclusion criteria. Results: After deduplication, 1,515 articles were screened, and 125 articles were included in this descriptive meta-analysis.
    [Show full text]
  • Visão De Futuro Para Produção De Antibióticos: Tendências De Pesquisa, Desenvolvimento E Inovação
    UNIVERSIDADE FEDERAL DO RIO DE JANEIRO CRISTINA D’URSO DE SOUZA MENDES SANTOS VISÃO DE FUTURO PARA PRODUÇÃO DE ANTIBIÓTICOS: TENDÊNCIAS DE PESQUISA, DESENVOLVIMENTO E INOVAÇÃO Rio de Janeiro EQ/UFRJ 2014 CRISTINA D ’U RSO DE SOUZA MENDES SANTOS VISÃO DE FUTURO PARA A PRODUÇÃO DE ANTIBIÓTICOS: TENDÊNCIAS DE PESQUISA, DESENVOLVIMENTO E INOVAÇÃO Tese de Doutorado apresentada ao Programa de Pós-Graduação em Tecnologia de Processos Químicos e Bioquímicos, Escola de Química, Universidade Federal do Rio de Janeiro, como requisito parcial à obtenção do título de Doutor em Ciências, D.Sc. Orientadora: Profa. Adelaide Maria de Souza Antunes, D.Sc. Rio de Janeiro 2014 Santos, Cristina d’Urso de Souza Mendes. Visão de futuro para produção de antibióticos: tendências de pesquisa, desenvolvimento e inovação / Cristina d’Urso de Souza Mendes Santos. - Rio de Janeiro, 2014. 216 f.: il.; 29,7 cm. Tese (Doutorado em Ciências) – Universidade Federal do Rio de Janeiro, Escola de Química, Programa de Pós-Graduação em Tecnologia de Processos Químicos e Bioquímicos, Rio de Janeiro, 2014. Orientadora: Adelaide Maria de Souza Antunes. 1. Antibióticos. 2. P&D na Indústria Farmacêutica. 3. Prospecção Tecnológica. 4. Patentes. I. Antunes, Adelaide Maria de Souza. II. Universidade Federal do Rio de Janeiro. Escola de Química. III. Visão de futuro para a produção de antibióticos: tendências de pesquisa, desenvolvimento e inovação. iv v Dedico esta tese à minha mãe querida e amada, que está no céu comemorando esta vitória, que é mais dela do que minha. Dedico também à minha filhinha Malu que sem entender foi a minha maior motivação para concluir esta tese.
    [Show full text]
  • Stembook 2018.Pdf
    The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances FORMER DOCUMENT NUMBER: WHO/PHARM S/NOM 15 WHO/EMP/RHT/TSN/2018.1 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances. Geneva: World Health Organization; 2018 (WHO/EMP/RHT/TSN/2018.1). Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data.
    [Show full text]
  • Multidrug Therapy Against Leprosy
    Multidrug therapy against leprosy Development and implementation over the past 25 years World Health Organization Geneva 2004 WHO Library Cataloguing-in-Publication Data Multidrug therapy against leprosy : development and implementation over the past 25 years / [editor]: H. Sansarricq. 1.Leprosy - drug therapy 2.Leprostatic agents - therapeutic use 3.Drug therapy, Combination 4.Health plan implementation - trends 5.Program development 6.World Health Organization I.Sansarricq, Hubert. ISBN 92 4 159176 5 (NLM classification: WC 335) WHO/CDS/CPE/CEE/2004.46 © World Health Organization 2004 All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The named authors alone are responsible for the views expressed in this publication. Printed by the WHO Document Production Services, Geneva, Switzerland Contents ________________________________________________ Acknowledgements ……………………………………………………………….
    [Show full text]
  • Pharmacological Aspects of the Chemotherapy of Leprosy
    Lepr. Rev. (l97S), 46 (Suppl.), 41-S1 Pharmacological Aspects of the Chemotherapy of Le p rosy G. A. ELLARD MR C Un it fo r Laboratory Studies of Tu berculosis, Royal Postgraduate Medicai School, Ducane Road, London W12 OHS PharmacologicaJ and bacteriological aspects of the treatment of lepromatous leprosy with dapsone, rifampicin, clofazimine, acedapsone, long-acting sulphona­ mides, thiacetazone, thiambutosine and other diphenyl thioureas are considered, and the problem of preventing lepromatous patients ultimately relapsing with drug-resistant strains of My co . leprae is discussed. The chemical structures of the most important antileprosy drugs are shown in Fig. I, together with their minimal inhibitory concentrations (MIes) against Myco. leprae as determined using the mouse footpad model. The part of each molecule that appears essential for antileprosy activity is shown in heavier type. Dapsone (DDS) is by far the most active antileprosy drug known, with an MIe against My co. leprae of only about 0.003 J.lg/ml (Ellard et ai. , 1971; Ozawa et aI. , 1971; Peters et ai. , 1972). Although other sulphonamides such as �ulpha­ dimethoxine and sulphadoxine are also active, their antileprosy activity is only about a 10,000th of that of DDS (Ellard et aI. , 1970). Acedapsone ar diacetyl-DDS (DADOS) is almost certainly devoid of intrinsic antileprosy activity, but is active in vivo because it is deacetylated by the body to DOS (Glazko et ai., 1968 ; Ozawa et aI. , 1971; Russell et ai. , 1973). Rifampicin is a semisynthetic antibiotic whose synthetic side-chain is not essential for antimycobacterial activity, but conveys important pharmacological properties on the drug.
    [Show full text]