Drugs for treating Buruli ulcer (Mycobacterium ulcerans disease)

Yotsu, Rie Roselyne; Richardson, Marty; Ishii, Norihisa

doi:10.1002/14651858.cd012118

Cited by 12 publications

(6 citation statements)

References 53 publications

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“…International BU studies report rates of paradoxical reactions with antibiotic therapy for BU between 1.9 and 26% . In contrast, 38.8% of the children in our cohort developed a paradoxical reaction, which was double the rate of our adult population.…”

Section: Discussioncontrasting

confidence: 60%

“…Surgery without antibiotics may be an effective option for selected small lesions; however, aggressive surgical resection is no longer required for most cases . Globally, this change in therapeutic strategy towards medical or combined therapy has resulted in reduced rates of invasive surgery and general anaesthesia, as well as reduced incidence of disability, disfigurement and disease recurrence . In resource‐limited settings of Western Africa, this also represents major advantages for children and families by reducing the financial strain of accessing limited and overburdened surgical services, and reducing the barriers to education and employment that disability, disfigurement and recurrent disease can pose …”

Section: Discussionmentioning

confidence: 99%

“…Internationally, BU has been most commonly reported in children in Africa . In African studies of BU, the median age of patients is 12–15 years, most cases identified are severe, and in children non‐ulcerated lesions (plaque or oedematous) and upper body location are more common than in adults …”

Section: Paediatric Diseasementioning

confidence: 99%

“…This process typically results in a painless nodule which erodes the overlying skin and ulcerates . BU most commonly occurs on the limbs, but is also occasionally seen on the face, and less commonly on non‐exposed areas of skin …”

mentioning

confidence: 99%

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Paediatric Buruli ulcer in Australia

Walker

Friedman

O'Brien

et al. 2019

J Paediatrics Child Health

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Aim: This study describes an Australian cohort of paediatric Buruli ulcer (BU) patients and compares them with adult BU patients. Methods: Analysis of a prospective cohort of all BU cases managed at Barwon Health, Victoria, from 1 January 1998 to 31 May 2018 was performed. Children were defined as ≤15 years of age. Results: A total of 565 patients were included: 52 (9.2%) children, 289 (51.2%) adults aged 16-64 years and 224 (39.6%) adults aged ≥65 years. Among children, half were female and the median age was 8.0 years (interquartile range 4.8-12.3 years). Six (11.5%) cases were diagnosed from 2001 to 2006, 14 (26.9%) from 2007 to 2012 and 32 (61.5%) from 2013 to 2018. Compared to adults, children had a significantly higher proportion of non-ulcerative lesions (32.7%, P < 0.001) and a higher proportion of severe lesions (26.9%, P < 0.01). The median duration of symptoms prior to diagnosis was shorter for children compared with adults aged 16-64 years (42 vs. 56 days, P = 0.04). Children were significantly less likely to experience antibiotic complications (6.1%) compared with adults (20.6%, P < 0.001), but had a significantly higher rate of paradoxical reactions (38.8%) compared with adults aged 16-64 (19.2%) (P < 0.001). Paradoxical reactions in children occurred significantly earlier than in adults (median 17 vs. 56 days, P < 0.01). Cure rates were similarly high for children compared to adults treated with antibiotics alone or with antibiotics and surgery. Conclusions: Paediatric BU cases in Australia are increasing and represent an important but stable proportion of Australian BU cohorts. Compared with adults, there are significant differences in clinical presentation and treatment outcomes.

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Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Paediatric Diseasementioning

confidence: 99%

mentioning

confidence: 99%

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Paediatric Buruli ulcer in Australia

Walker

Friedman

O'Brien

et al. 2019

J Paediatrics Child Health

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“…rifampicin and clarithromycin) based on trials and case reports. 4 Wound care and, in severe cases, surgical interventions are also essential components in treatment of BU. 5 Rehabilitation is important especially when the joints are involved, like in our case.…”

mentioning

confidence: 99%