The chemotherapy of multibacillary leprosy with dapsone alone has resulted after 15-20 years in the selection and the diffusion of dapsone resistant Mycobacterium leprae. To overcome dapsone resistance, to prevent the selection of organisms resistant to other drugs and to kill the largest proportion of sensitive M. leprae, the chemotherapy of leprosy must rely, as chemotherapy of tuberculosis, upon the combination of several drugs. Rifampicin is included in all drug combinations recommended by WHO. The drug combinations have to be given for at least six months in patients with paucibacillary leprosy and two years in patients with multibacillary leprosy.
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