Antimicrobial Treatment of Mycobacterium ulcerans Infection

摘要: MacCallum and coworkers described Buruli ulcer (BU) as an infectious disease caused by Mycobacterium ulcerans in Victoria, Australia. They first considered the skin lesions their patients to be tuberculosis or leprosy, when they observed numerous acid-fast bacilli biopsy specimens [1]. The typical duration of illness was between 1 2 years; treatment essentially surgical. With advent chemotherapy for [2–4], later doctors made individual attempts treat with anti-tuberculosis anti-leprosy drugs. anecdotal evidence suggested poor no response rifampicin monotherapy [5], despite fact that vitro susceptibility 33 strains M. good [6]. A randomized clinical trial British Medical Research Council county (now called Nakasongola; Uganda) failed show any benefit from clofazimine, a drug then marketed leprosy [7]. small-sized cotrimoxazole (18 participants; 12 evaluable) inconclusive [8]. study Cote d’Ivoire compared combination dapsone placebo; follow-up limited; size decreased slightly faster intervention group but baseline characteristics both groups differed, did not allow draw firm conclusions about effectiveness these drugs [9]. By turn millennium, discrepancy efficacy [6] clarithromycin [10] lack prompted stressing need well-designed well-powered trials, meantime, also improve early detection surgical [11].