title: Clinical and bacteriological efficacy of rifampin-streptomycin combination for two weeks followed by rifampin and clarithromycin for six weeks for treatment of Mycobacterium ulcerans disease.
abstract: Buruli ulcer, an ulcerating skin disease caused by Mycobacterium ulcerans infection, is common in tropical areas of western Africa. We determined the clinical and microbiological responses to administration of rifampin and streptomycin for 2 weeks followed by administration of rifampin and clarithromycin for 6 weeks in 43 patients with small laboratory-confirmed Buruli lesions and monitored for recurrence-free healing. Bacterial load in tissue samples before and after treatment for 6 and 12 weeks was monitored by semiquantitative culture. The success rate was 93%, and there was no recurrence after a 12-month follow-up. Eight percent had a positive culture 4 weeks after antibiotic treatment, but their lesions went on to heal. The findings indicate that rifampin and clarithromycin can replace rifampin and streptomycin for the continuation phase after rifampin and streptomycin administration for 2 weeks without any apparent loss of efficacy.
authors: Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana.
authors: Richard O
authors: RO
authors: Phillips
authors: Fred S
authors: FS
authors: Sarfo
authors: Mohammed K
authors: MK
authors: Abass
authors: Justice
authors: J
authors: Abotsi
authors: Tuah
authors: T
authors: Wilson
authors: Mark
authors: M
authors: Forson
authors: Yaw A
authors: YA
authors: Amoako
authors: William
authors: W
authors: Thompson
authors: Kingsley
authors: K
authors: Asiedu
authors: Mark
authors: M
authors: Wansbrough-Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D054312:Buruli Ulcer / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D017291:Clarithromycin / Q000627:therapeutic use*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005869:Ghana; D006801:Humans; D008875:Middle Aged; D019911:Mycobacterium ulcerans / Q000187:drug effects* / Q000502:physiology; D012293:Rifampin / Q000627:therapeutic use*; D012867:Skin / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D013307:Streptomycin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin; D012293:Rifampin; D013307:Streptomycin