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    Apr 11, 2021
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    Outcomes for Mycobacterium ulcerans infection with combined surgery and antibiotic therapy: findings from a south-eastern Australian case series.

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    Authors
    O'Brien, D P
    Hughes, A
    Cheng, A C
    Henry, M J
    Callan, P
    McDonald, A
    Holten, I
    Birrell, M
    Sowerby, J M
    Johnson, P D
    Athan, E
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    Affiliation
    Barwon Health, Geelong, Victoria, Australia. daniel.obrien@amsterdam.msf.org
    Issue Date
    2007-01-15
    
    Metadata
    Show full item record
    Journal
    The Medical Journal of Australia
    Abstract
    OBJECTIVE: To describe the effect of antibiotics on outcomes of treatment for Buruli or Bairnsdale ulcer (BU) in patients on the Bellarine Peninsula in south-eastern Australia. DESIGN: Observational, non-randomised study with data collected prospectively or through medical record review. PATIENTS AND SETTING: All 40 patients with BU managed by staff of Barwon Health's Geelong Hospital (a public, secondary-level hospital) between 1 January 1998 and 31 December 2004. MAIN OUTCOME MEASURES: Epidemiology, clinical presentation, diagnosis, treatment and clinical outcomes. RESULTS: There were 59 treatment episodes; 29 involved surgery alone, 26 surgery plus antibiotics, and four antibiotics alone. Of 55 episodes where surgery was performed, minor surgery was required in 22, and major surgery in 33. Failure rates were 28% for surgery alone, and 19% for surgery plus antibiotics. Adjunctive antibiotic therapy was associated with increased treatment success for lesions with positive histological margins (P < 0.01), and lesions requiring major surgery for treatment of a first episode (P < 0.01). The combination of rifampicin and ciprofloxacin resulted in treatment success in eight of eight episodes, and no patients ceased therapy because of side effects with this regimen. CONCLUSIONS: Adjunctive antibiotic therapy may increase the effectiveness of BU surgical treatment, and this should be further assessed by larger randomised controlled trials. The combination of rifampicin and ciprofloxacin appears the most promising.
    Publisher
    Medical Society of Australia
    PubMed ID
    17223763
    Additional Links
    http://www.mja.com.au/public/issues/186_02_150107/obr10433_fm.pdf
    Language
    en
    Description
    To access this article, click on "Additional Links"
    ISSN
    0025-729X
    Collections
    Other Diseases

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