Available evidence which may aid a decision concerning which of the thioamides, ethionamide or prothionamide should be recommended for use in the treatment of lepromatous leprosy is inconclusive. The drugs possess similar antimycobacterial activities, but earlier work has suggested that after oral dosage ethionamide may give rise to higher blood levels than prothionamide. We report on investigations designed to examine whether this finding is as a result of different systemic availabilities, by comparing blood levels fo llowing intravenous and oral administrations. We conclude that the drugs' pharmacokinetics are very similar, each having high bioavailabilities, and that other fa ctors such as cost may be more important determinants as to which thioamide should be used.

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A study of urinary dapsone/creatinine (D/C) concentration ratios has been per formed on 852 leprosy patients in the Rangoon and Mandalay regions of Burma. The results show that, by comparison with in-patients who are assumed to be compliant with their therapy, hospital outpatients and urban and rural clinic patients had overall compliance rates of only 74% and 24% respectively. In each group, substan tial numbers of patients were identified who had taken no dapsone (DDS) tablets whatsoever. The findings are in line with similar studies performed in other countries and they indicate an urgent need to reassess the existing programme of treatment supervision particularly in the urban and rural clinic environments.