Abstract | BACKGROUND: METHODOLOGY/PRINCIPAL FINDINGS: Analysis was performed of prospectively collected data including all primary Mycobacterium ulcerans infections treated at Barwon Health between 1998 and 2010. Medical treatment involved antibiotic use for more than 7 days; surgical treatment involved surgical excision of a lesion. Treatment success was defined as complete lesion healing without recurrence at 12 months follow-up. A complication was defined as an adverse event attributed to an antibiotic that required its cessation. A total of 133 patients with 137 lesions were studied. Median age was 62 years (range 3-94 years). 47 (34%) had surgical treatment alone, and 90 (66%) had combined surgical and medical treatment. Rifampicin and ciprofloxacin comprised 61% and rifampicin and clarithromycin 23% of first-line antibiotic regimens. 13/47 (30%) treated with surgery alone failed treatment compared to 0/90 (0%) of those treated with combination medical and surgical treatment (p<0.0001). There was no difference in treatment success rate for antibiotic combinations containing a fluoroquinolone (61/61 cases; 100%) compared with those not containing a fluoroquinolone (29/29 cases; 100%). Complication rates were similar between ciprofloxacin and rifampicin (31%) and rifampicin and clarithromycin (33%) regimens (OR 0.89, 95% CI 0.27-2.99). Paradoxical reactions during treatment were observed in 8 (9%) of antibiotic treated cases. CONCLUSIONS:
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Authors | Daniel P O'Brien, Anthony McDonald, Peter Callan, Mike Robson, N Deborah Friedman, Andrew Hughes, Ian Holten, Aaron Walton, Eugene Athan |
Journal | PLoS neglected tropical diseases
(PLoS Negl Trop Dis)
Vol. 6
Issue 1
Pg. e1473
(Jan 2012)
ISSN: 1935-2735 [Electronic] United States |
PMID | 22272368
(Publication Type: Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Fluoroquinolones
- Rifampin
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Anti-Bacterial Agents
(administration & dosage, therapeutic use)
- Australia
(epidemiology)
- Buruli Ulcer
(drug therapy, epidemiology, surgery)
- Child
- Child, Preschool
- Cohort Studies
- Drug Therapy, Combination
- Female
- Fluoroquinolones
(administration & dosage, therapeutic use)
- Humans
- Male
- Middle Aged
- Mycobacterium ulcerans
- Rifampin
(administration & dosage, therapeutic use)
- Treatment Outcome
- Young Adult
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