Optimizing dosing strategies for children with leprosy: A weight-banded dosing approach

Weight-banded multidrug therapy dosing for children aged 2 to <10 years achieves adult-equivalent rifampicin, clofazimine, and dapsone exposures across most weight bands.

• Why it matters: Current WHO mg/kg guidance for under-10s is hard to implement and may produce inconsistent exposures, creating operational and pharmacokinetic gaps in pediatric leprosy treatment.
• What they did: A pharmacokinetic simulation used the WHO dosing tool to harmonize rifampicin, clofazimine, and dapsone regimens by weight band, targeting adult-equivalent exposure (80-125% of adult AUC).
• The result: Exposures modestly exceeded 125% at the lower end of selected bands but stayed below safety benchmarks; dapsone matched current leprosy dosing, and existing 10-14-year blister packs fit weights 25-39.9 kg with minimal changes for 6-24.9 kg.

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