title: Treating Mycobacterium ulcerans disease (Buruli ulcer): from surgery to antibiotics, is the pill mightier than the knife?
abstract: Until 2004, the skin disease known as Buruli ulcer, caused by Mycobacterium ulcerans, could only be treated by surgery and skin grafting. Although this worked reasonably well on early lesions typically found in patients in Australia, the strategy was usually impractical on large lesions resulting from diagnostic delay in patients in rural West Africa. Based on promising preclinical studies, treatment trials in West Africa have shown that a combination of rifampin and streptomycin administered daily for 8 weeks can kill M. ulcerans bacilli, arrest the disease, and promote healing without relapse or reduce the extent of surgical excision. Improved treatment options are the focus of research that has increased tremendously since the WHO began its Global Buruli Ulcer Initiative in 1998.
authors: Johns Hopkins University Center for Tuberculosis Research, 1551 Jefferson Street, #154, Baltimore, MD 21287, USA. pconver1@jhmi.edu
authors: Paul J
authors: PJ
authors: Converse
authors: Eric L
authors: EL
authors: Nuermberger
authors: Deepak V
authors: DV
authors: Almeida
authors: Jacques H
authors: JH
authors: Grosset
mesh_terms: D000293:Adolescent; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D054312:Buruli Ulcer / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery*; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D051379:Mice; D019911:Mycobacterium ulcerans / Q000187:drug effects*; D012293:Rifampin / Q000627:therapeutic use; D013307:Streptomycin / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D012293:Rifampin; D013307:Streptomycin