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Our study didn't find any significant difference between combination therapy (rifampicin+dapsone) and monotherapy (rifampicin) according to decrease in B.I., M.I., ENL occurrence, or improvement in clinical features. Rapid decrease in M.I. was observed in all patients, and all cases had reached baseline M.I. within 15 months of therapy. Although some cases showed an increase in B.1. before the ninth or tenth month of treatment(four patients in the groups receiving combination therapy), all patients had a markedly reduced B.I. after 18 months of treatment, and 7 of the 15 cases had converted from B.I. positive to negative. ENL occurred during treatment in four patients, but did not involve a concurrent rise in B.I. or M.I., and after 18 months, no patient was in ENL. Paripheral clinical features were markedly improved after a year of therapy, but nerve thickening showed only mild improvement, or no improvement in some cases. This may be due to the presence of "persister organisms", or could simply be due to the characteristic of nerve tissue to collagenize in the presence of fragmented bacili. We conclude that rifampicin, whether in combination with dapsone or by itself, is much more effective than sulfone therapy in eradication of M. leprae.
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