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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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dc.contributor Barwon Health, Geelong, Victoria, Australia. daniel.obrien@amsterdam.msf.org
dc.creator O'Brien, D P
dc.creator Hughes, A
dc.creator Cheng, A C
dc.creator Henry, M J
dc.creator Callan, P
dc.creator McDonald, A
dc.creator Holten, I
dc.creator Birrell, M
dc.creator Sowerby, J M
dc.creator Johnson, P D
dc.creator Athan, E
dc.date 2007-01-15
dc.date.accessioned 2017-01-31T07:09:35Z
dc.date.available 2017-01-31T07:09:35Z
dc.identifier Outcomes for Mycobacterium ulcerans infection with combined surgery and antibiotic therapy: findings from a south-eastern Australian case series. 2007, 186 (2):58-61 Med. J. Aust.
dc.identifier 0025-729X
dc.identifier 17223763
dc.identifier The Medical Journal of Australia
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/17726
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/123456789/125146
dc.description To access this article, click on "Additional Links"
dc.description 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.
dc.language en
dc.publisher Medical Society of Australia
dc.relation http://www.mja.com.au/public/issues/186_02_150107/obr10433_fm.pdf
dc.rights Archived on this site with thanks to the Medical Society of Australia
dc.title Outcomes for Mycobacterium ulcerans infection with combined surgery and antibiotic therapy: findings from a south-eastern Australian case series.


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