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KMID : 0386319680050010101
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Korean Leprosy Bulletin
1968 Volume.5 No. 1 p.101 ~ p.107
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D.D.S. Dosage in 1967
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Wilson,G.K
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Abstract
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Abstract
Out of approximately 700 out-patients on the monthly attendance register, 30 patients who had received D.D.S. for more than 1 month at a dose of less than 200 mg per week were selected, the low dose taken mainly after the occurrence of reaction and neuritis, once after D.D.S, dermatitis.
Because doses of D.D.S. taken by the patient himself before the first visit was usually very high, this was deducted for comparison.
Charts were made to indicate the Bacterial index, Granularity Index and Morphologic Index as available, showing also the corresponding therapy used. The Morphologic Index was found to be a much more reliable means of assessing progress.
122 mg D. D. S. per week was the average dose taken by these patients.
82 mg D.D.S. per week was the average dose taken by these patients under treatment with the Leprosy Mission.
This confirms the literature that 100 mg D.D.S. per week is an adequate therapeutic dose producing fewer reactions and neuritis.
Trials are required to confirm that 100mg D.D.S. per week is suitable for all types of leprosy.
I . Introduction
In 1946, Cochrane and others it ed D.D.S. parenterally in doses of 1.25 Gm. twice fly with encouraging results, 12,:50(1 rlxg X2 per week! Trials were made with oral D.D.S. especially by .Loxve and the WHO Expert Committee in 195´3 recommended a maximum dose of 600 mg per wedd., given in two divided dses. in 1953,The 46RC, V 0 Leprosy Congress at Tokyo .recomanen d B0 m g
daily maximum, or 350 mg per week and Professor Joon Lew (6) was advocating 300 mg per week maximum for Korean patients.
In 1965, several worker (7)(8)(9) indicated that 100 mg of D. D. S. given orally twice weekly is as effective therapeutically as the standard dose, and they have also suggested that the incidence -of E.N.L. was less at this lower dose.
In 1967, Pettit and Rees(5) showed on a smal pilot trial that 50 mg D.D.S. twice weekly orally was shown to produce as satisfactory bacterial,
histologic and clinical improvement as the higher doses that are -usually used.
D.D.S. is still the most potent drug against leprosy. This has been proved in tissue culture experiments by Shepard, McRae and Habas(1), who found M. leprae is extremely sensitive to D.D.S. In he summary, the authors state, 4´The activity against M. leprae of 4.4´- diamn nodiphenyl sulphone(D.D.S.) was tested in mice by feeding a series of diets containing the drug in concentrations ranging from 0.03 to 0.00001%. Multiplication of M. leprae -vas completely suppressed at aI levels. The lowest D.D.
S. in take was a hundred times less than the least amomt required to produce .ically detectable amounts in the blood(0.2-0.,Bmg/ml). Floch and Leuiller (2) have shown t after the ad inistration of large doses of D.D.S., the drug is toncentrated in the liver wA ten& to produce haemolysis. Also Shepard and Chang(3) have shown that of 11 anttituberc us Cdr s tested against M. kprae in moues kotpads, - D.D.S- suppressed M leprae multiplication completely, even in the smallest dosage used. D.D.S. is therefore still the most potent drug
against leprosy..
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