Browsing by Author "Thompson, William"

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    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
    (Antimicrobial Agents and Chemotherapy, 2014-02) Phillips, Richard Odame; Sarfo, Fred Stephen; Abass, Mohammed K.; Abotsi, Justice; Wilson, Tuah; Forson, Mark; Amoako, Yaw A.; Thompson, William; Asiedu, Kingsley; Wansbrough-Jonesc, Mark Wansbrough-Jonesc
    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.
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    Randomised trial to compare clarithromycin (extended release)- rifampicin and streptomycin-rifampicin for early, limited lesions of M. ulcerans infection
    (The Lancet, 2019-10-01) Phillips, Richard Odame; Robert, Jerome; Abass, K. Mohamed; Thompson, William; Sarfo, Fred Stephen; et. al
    Background Buruli ulcer (Mycobacterium ulcerans infection) is a Neglected Tropical Disease characterised by severe subcutaneous necrosis, with occasional bone involvement. Being reported from 33 countries, it is most prevalent in West and Central Africa, and Australia. In Africa, the major burden is borne by poor rural children. If left untreated, Buruli ulcer may progress to cause severe suffering and ultimately stigmatising disability resulting in school drop-out and loss of income. Standard antimicrobial treatment with oral rifampicin 10 mg/kg and intramuscular streptomycin 15 mg/kg for eight weeks (RS8) is highly effective but streptomycin injections are painful and may cause hearing loss. Methods Between January 2013 and December 2017, we conducted an open label randomised multicentre phase III clinical trial with noninferiority design comparing fully oral treatment with rifampicin and clarithromycin 15 mg/kg extended release (RC8) with RS8. A sample size of 332 participants was calculated to detect inferiority of CR8 by a margin of 12%.
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    A Severe Case of Buruli Ulcer Disease with Pleural Effusions
    (PLOS Neglected Tropical Diseases, 2014-06-19) Sarfo, Fred Stephen; Phillips, Richard Odame; Thompson, William; Paintsil, Albert; Abass, Mohammed K.; et. al
    Patient GO is an 8-year-old student from Drobonso, a Buruli ulcer–endemic community in the Sekyere Afram Plains of the Ashanti region of Ghana. She presented with a month’s history of a painless nodule on the anterior chest which started increasing in size rapidly over the course of two weeks. After applying herbal preparations on the lesion and observing no improvement in symptoms, she sought medical attention through which a course of oral amoxycillin was prescribed for a week. However, her lesion continued to enlarge with involvement of her anterior and posterior chest walls and ulcerations over the left anterior cervical triangle and midsternal region. Upon the recommendation of a former patient from the same endemic region, she came to the Buruli ulcer clinic at the Agogo Presbyterian Hospital on the 24th of February 2011. On examination, the patient looked fairly stable and was afebrile (36.9uC), not pale, and anicteric with no regional lymphadenopathy. Her chest was clinically clear with a respiratory rate of 14 cycles/min. The most significant finding was an extensive oedematous lesion involving the chest and neck regions with two deep ulcerations (Figure 1). She weighed 31 kg at diagnosis (95th centile in weight for age). Swab samples obtained from the ulcer were positive by PCR for IS2404, acid-alcoholfast bacilli, and Mycobacterium ulcerans culture on Lowenstein-Jensen culture slopes.