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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/15206

Title: Pharmacologic management of Mycobacterium ulcerans infection
Authors: Phillips, Richard Odame
Van Der Werf, Tjip S
Stienstra, Ymkje
Barogui, Yves T
Converse, Paul J
Keywords: clinical trials
pharmacokinetics
Mycobacterium ulcerans;
Buruli ulcer
treatment
pharmacology
Issue Date: 2020
Publisher: Taylor & Francis
Citation: Taylor & Francis ,2020
Abstract: Introduction: Pharmacological treatment of Buruli ulcer (Mycobacterium ulcerans infection; BU) is highly effective, as shown in two randomized trials in Africa. Areas covered: We review BU drug treatment – in vitro, in vivo and clinical trials (PubMed: ‘(Buruli OR (Mycobacterium AND ulcerans)) AND (treatment OR therapy).’ We also highlight the pathogenesis of M. ulcerans infection that is dominated by mycolactone, a secreted exotoxin, that causes skin and soft tissue necrosis, and impaired immune response and tissue repair. Healing is slow, due to the delayed wash-out of mycolactone. An array of repurposed tuberculosis and leprosy drugs appears effective in vitro and in animal models. In clinical trials and observational studies, only rifamycins (notably, rifampicin), macrolides (notably, clarithromycin), aminoglycosides (notably, streptomycin) and fluoro quinolones (notably, moxifloxacin, and ciprofloxacin) have been tested. Expert opinion: A combination of rifampicin and clarithromycin is highly effective but lesions still take a long time to heal. Novel drugs like telacebec have the potential to reduce treatment duration but this drug may remain unaffordable in low-resourced settings. Research should address ulcer treatment in general; essays to measure mycolactone over time hold promise to use as a readout for studies to compare drug treatment schedules for larger lesions of Buruli ulcer.
Description: This article is published at Taylor & Francis, and also available at doi.org/10.1080/17512433.2020.1752663
URI: https://doi.org/10.1080/17512433.2020.1752663
http://hdl.handle.net/123456789/15206
Appears in Collections:College of Health Sciences

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