***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: UNLABELLED Recently antimicrobials of the fluoroquinolone class ( pefloxacin and ofloxacin ) were found far more effective against Mycobacterium leprae in studies with both mice and patients than dapsone and clofazimine . As multicentre trial participants , we evaluated the therapeutic efficacy , in terms of rate of relapse , of two new multidrug regimens containing ofloxacin , comparing them to 1 year and 2 years of st and ard WHO-MDT regimen in multibacillary ( MB ) leprosy patients . A total of 198 MB patients were recruited to participate in a r and omized , double-blind trial . Among those , 53 patients were treated with 1 year of WHO-MDT ( a regimen including dapsone , clofazimine , and rifampin ) , 55 patients received 1 year of WHO-MDT plus an initial 1 month of daily ofloxacin , 63 patients were treated with 1 month of daily rifampin and daily ofloxacin , whereas 27 were treated with 2 years of WHO-MDT . Patients were regularly monitored for signs of relapse , in at least 7 years follow-up after being released from treatment . RESULTS Relapse occurred in those treated with 1-month regimen alone at a significant higher rate ( P < 0.001 ) : 388 % , whereas in the other three regimens that included WHO-MDT it ranged from 0 to 5 % . This study found that a short-course treatment for MB patients with rifampicin-ofloxacin combination had a higher failure rate . The addition of one month of daily ofloxacin to 12 months MB WHO-MDT did not increase its efficacy OBJECTIVES To compare the efficacy of a 4-week ofloxacin-containing regimen and the st and ard WHO-MDT regimen for PB leprosy , in terms of the rate and timing of relapse after treatment completion . DESIGN 124 PB patients were enrolled in a r and omised , double-blind trial . Of these , 66 received the st and ard 6-month WHO-MDT regimen , whereas 58 received 28 daily supervised doses of rifampicin 600 mg + ofloxacin 400 mg , plus 5 months of placebo . Patients were regularly monitored for clinical response and for signs of relapse after treatment completion . RESULTS Patients enrolled in the ofloxacin  group had a mean follow-up of 10.8 years ( 628 patient-years ) with 1 early relapse at 3 years after treatment completion . On relapse , this patient remained smear negative but was reclassified by current WHO criteria ( > or = 6 skin lesions ) as multibacillary ( MB ) . Patients on the WHO-MDT regimen had a mean follow-up of 11.3 years ( 749 patient-years ) with two late relapses at 8 and 12 years , both still classified as PB on relapse . CONCLUSION In conclusion , both regimens appeared generally efficacious , and , in particular , result ed in few relapses A bacteriological follow-up of 16 lepromatous patients with a high initial Bacteriological Index ( BI ) showed that in 8 r and omly selected patients who received single doses of ICRC Vaccine ( C44 )  at the onset of multidrug therapy , the average reduction of BI was from 4.4 + to 1 + in 2 years--3 of these patients became negative and 3 showed BI 1 + or less . Comparable bacteriological assessment s in 8 non-vaccinated but otherwise similar patients showed an average reduction of BI from 4.7 + to 2.6 + , i.e. consistent with the expected response to MDT in lepromatous patients . Here we discuss the role of immunotherapy and the selection of a desirable antileprosy vaccine in the context of fixed- duration MDT Eighty paucibacillary leprosy cases were r and omly put on two different multidrug regimens for 6 months followed by dapsone monotherapy . Regimen I was according to WHO ( 1982 ) recommendations consisting of Dapsone and six once a month rifampicin . In regimen II in addition to above two constituents , clofazimine was added 100 mg on alternate days . Dapsone thereafter was continued in both the regimens upto one year . The efficacy , acceptability and side effects of multidrug regimens were observed for a period of one year . Histopathological assessment was done on completion of multidrug therapy in all cases . A comparative evaluation of effect of two multidrug regimens in paucibacillary leprosy patients is reported . Addition of clofazimine over WHO ( 1982 ) recommended regimen appears to have no added benefit . The duration of WHO ( 1982 ) recommended regimens was found to be inadequate in many cases One of the technical problems relating to the multidrug therapy of leprosy is the slow decrease in the bacteriological index ( BI ) in multibacillary patients . In this study we have compared a regimen containing rifampicin given daily for 9 months with the st and ard WHO multidrug regimen for multibacillary leprosy . We have found , at the end of two years , a significantly greater fall of BI in patients who had received the regimen containing daily rifampicin as compared to those who had received pulsed doses of rifampicin . The doses of dapsone and clofazimine  were similar in these two groups . It appears that daily administration of rifampicin may be useful in treating multibacillary patients in whom reduction in the BI is slower than expected . However , in view of its high cost and the very much increased incidence of type-2 lepra reactions and hepatitis , daily rifampicin therapy can not be recommended for a control programme A prospect i ve study is being undertaken in Western Kenya to evaluate the effectiveness and tolerability of WHO-MDT , while at the same time comparing it to a modified multidrug regimen , which is rifampicin 1500 mg at the onset supervised , and repeated after 3 months and dapsone 100 mg daily for 6 months . Preliminary analysis done on 127 cases admitted into the study are presented . The inactivity index observed between 0 - 12 weeks was 20 % for WHO-MDT and 47 % for modified-MDT ( p less than 0.01 ) . The inactivity index observed between 0 - 24 weeks was 63.3 % for WHO-MDT and 82.3 % for modified-MDT ( p less than 0.05 ) . The inactivity index observed between 0 - 32 weeks was 83 % for WHO-MDT , and 88 % for modified-MDT . Type 1 reaction was noted in 23.3 % on those on WHO-MDT , and 20.3 % on those cases on modified-MDT ( p greater than 0.1 ) . Compliance rate was 93.8 % for those on WHO-MDT and 95.2 % on those on modified MDT . All regimens were well tolerated . These preliminary results indicate that MDT is effective in treatment of paucibacillary leprosy , and also that clinical cure can be achieved in much shorter duration , particularly with higher dosage of rifampicin In a double blind study , 300 PB patients ( smear negative , indeterminate , tuberculoid and borderline tuberculoid ) were r and omly allotted to two regimens , the control subjects ( 150 patients ) receiving the st and ard WHO multidrug regimen of six doses of once a month rifampicin with daily dapsone therapy for six months , while the study group ( 150 patients ) receiving  50 mg of clofazimine daily for six months in addition to the WHO regimen . After stoppage of therapy all the patients were followed up on placebo . The regimens were well tolerated . In 7.5 % of patients on clofazimine containing regimen , the lesions showed persisting activity at the time of stoppage of therapy , compared with 16 % on the control regimen . This activity subsided spontaneously , more rapidly , in the study group ( 80 % compared with 30 % in the control group ) in six months . Two patients in the control group and one patient in the study group developed late reaction . There were no relapses in the study group , whereas , two patients have relapsed in the control group during a follow-up of 2.5 to 3.5 years UNLABELLED We conducted r and omized double-blind trial for single-dose of Rifampicin , Ofloxacin and Minocycline ( ROM ) compared to WHO-PB-MDT among paucibacillary ( PB ) leprosy patients with 2 - 5 skin lesions . We enrolled 1526 patients from five centres ( ROM=762 ; WHO-PB-MDT=764 ) and followed them for 36 months posttreatment during 1998 - 2003 . We generated information on clearance of skin lesions and relapse rates per 100 person-years ( PY ) for all the five centres . At base-line , the patients in the two arms were comparable . Complete clearance of skin lesions was similar ( 72 % vs. 72.1 % ; p=0.95 ) in both the arms . Clinical scores declined steadily and equally . Difference in relapse rates was statistically highly significant ( ROM=1.13 and WHO-PB-MDT=0.35 per 100 PY ; mid-p exact=0.001016 ) . Twenty eight of 38 of these relapses occurred within 18 months . In all , 10 suspected adverse drug reactions were.observed ( ROM=2 ; WHO-PB-MDT=8 ) . We extended the follow-up to 48 months for 1082 of 1526 patients from two programme-based centres . No further relapses occurred . Decline in clinical score was not dependent on age , gender , number of lesions or affected body parts . Single dose ROM , though less effective than the st and ard WHO-PB-MDT regimen conceptually offers an alternative treatment regimen for PB leprosy patients with 2 - 5 lesions only when careful follow-up for relapse is possible . Registered at the Clinical Trials Registry of India ; REGISTRATION NUMBER Background Leprosy control is based on early diagnosis and multidrug therapy . For treatment purpose s , leprosy patients can be classified as paucibacillary ( PB ) or multibacillary ( MB ) , according to the number of skin lesions . Studies regarding a uniform treatment regimen ( U-MDT ) for all leprosy patients have been encouraged by the WHO , rendering disease classification unnecessary . Methodology and findings An independent , r and omized , controlled clinical trial conducted from 2007 to 2015 in Brazil , compared main outcomes ( frequency of reactions , bacilloscopic index trend , disability progression and relapse rates ) among MB patients treated with a uniform regimen/U-MDT ( dapsone+rifampicin+clofazimine for six months )  versus WHO regular-MDT/R-MDT ( dapsone+rifampicin+clofazimine for 12 months ) . A total of 613 newly diagnosed , untreated MB patients with high bacterial load were included . There was no statistically significant difference in Kaplan-Meyer survival function regarding reaction or disability progression among patients in the U-MDT and R-MDT groups , with more than 25 % disability progression in both groups . The full mixed effects model adjusted for the bacilloscopic index average trend in time showed no statistically significant difference for the regression coefficient in both groups and for interaction variables that included treatment group . During active follow up , four patients in U-MDT group relapsed representing a relapse rate of 2.6 per 1000 patients per year of active follow up ( 95 % CI [ 0·81 , 6·2 ] per 1000 ) . During passive follow up three patients relapsed in U-MDT and one in R-MTD . As this period corresponds to passive follow up , sensitivity analysis estimated the relapse rate for the entire follow up period between 2·9- and 4·5 per 1000 people per year . Conclusion Our results on the first r and omized and controlled study on U-MDT together with the results from three previous studies performed in China , India and Bangladesh , support the hypothesis that UMDT is an acceptable option to be adopted in endemic countries to treat leprosy patients in the field worldwide . Trial registration Clinical Trials.gov : UNLABELLED Leprosy still remains a public health problem mainly in Asia , Africa and South America . The WHO Expert Committee on Leprosy recommended , in 1997 , the simplified treatment of leprosy for multibacillary ( MB ) cases , by reducing the duration of treatment from 24 to 12 months . From the operational point of view even this reduced duration is still long and monthly supervised drug administration may not always be practical in those areas where the accessibility is difficult and health infrastructure weak . The present study was carried out to compare the safety and efficacy of a new fixed duration regimen consisting of four bactericidal drugs with WHO/MDT ( MB ) . METHODS Thirty adult patients were r and omly allocated to two groups . Group 1 ( 18 patients ) received a new regimen of daily rifampicin 600 mg , sparfloxacin 200 mg , clarithromycin 500 mg and minocycline 100 mg for 12 weeks . Group 2 ( 12 patients ) received WHO/MDT ( MB ) for 12 months . A detailed clinical evaluation and laboratory investigations , BI and MI were done at the baseline , every 4 weeks for 12 weeks 
    Output:
    
Not better treatment than the implemented by the WHO was found .