title: Clinical efficacy of combination of rifampin and streptomycin for treatment of Mycobacterium ulcerans disease.
abstract: We have evaluated the clinical efficacy of the combination of oral rifampin at 10 mg/kg of body weight and intramuscular streptomycin at 15 mg/kg for 8 weeks (RS8), as recommended by the WHO, in 160 PCR-confirmed cases of Mycobacterium ulcerans disease. In 152 patients (95%) with all forms of disease from early nodules to large ulcers, with or without edema, the lesions healed without recourse to surgery. Eight patients whose ulcers were healing poorly had skin grafting after completion of antibiotics. There were no recurrences among 158 patients reviewed at the 1-year follow-up. The times to complete healing ranged from 2 to 48 weeks, according to the type and size of the lesion, but the average rate of healing (rate of reduction in ulcer diameter) varied widely. Thirteen subjects had positive cultures for M. ulcerans during or after treatment, but all the lesions healed without further antibiotic treatment. Adverse events were rare. These results confirm the efficacy of RS8 delivered in a community setting.
authors.affiliation: Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Fred Stephen
authors.initials: FS
authors.lastname: Sarfo
authors.forename: Richard
authors.initials: R
authors.lastname: Phillips
authors.forename: Kingsley
authors.initials: K
authors.lastname: Asiedu
authors.forename: Edwin
authors.initials: E
authors.lastname: Ampadu
authors.forename: Nana
authors.initials: N
authors.lastname: Bobi
authors.forename: E
authors.initials: E
authors.lastname: Adentwe
authors.forename: Awuli
authors.initials: A
authors.lastname: Lartey
authors.forename: Ishmael
authors.initials: I
authors.lastname: Tetteh
authors.forename: M
authors.initials: M
authors.lastname: Wansbrough-Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D054312:Buruli Ulcer / Q000188:drug therapy* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019911:Mycobacterium ulcerans / Q000187:drug effects*; D012293:Rifampin / Q000627:therapeutic use*; D013307:Streptomycin / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D012293:Rifampin; D013307:Streptomycin