Towards Rational Use of Antibiotics for Suspected Secondary Infections in Buruli Ulcer Patients

Yves T. Barogui*, Sandor Klis, Honore Sourou Bankole, Ghislain E. Sopoh, Solomon Mamo, Lamine Baba-Moussa, Willem L. Manson, Roch Christian Johnson, Tjip S. van der Werf, Ymkje Stienstra

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

22 Citations (Scopus)
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Abstract

Background: The emerging disease Buruli ulcer is treated with streptomycin and rifampicin and surgery if necessary. Frequently other antibiotics are used during treatment.

Methods/Principal Findings: Information on prescribing behavior of antibiotics for suspected secondary infections and for prophylactic use was collected retrospectively. Of 185 patients that started treatment for Buruli ulcer in different centers in Ghana and Benin 51 were admitted. Forty of these 51 admitted patients (78%) received at least one course of antibiotics other than streptomycin and rifampicin during their hospital stay. The median number (IQR) of antibiotic courses for admitted patients was 2 (1, 5). Only twelve patients received antibiotics for a suspected secondary infection, all other courses were prescribed as prophylaxis of secondary infections extended till 10 days on average after excision, debridement or skin grafting. Antibiotic regimens varied considerably per indication. In another group of BU patients in two centers in Benin, superficial wound cultures were performed. These cultures from superficial swabs represented bacteria to be expected from a chronic wound, but 13 of the 34 (38%) S. aureus were MRSA.

Conclusions/Significance: A guide for rational antibiotic treatment for suspected secondary infections or prophylaxis is needed. Adherence to the guideline proposed in this article may reduce and tailor antibiotic use other than streptomycin and rifampicin in Buruli ulcer patients. It may save costs, reduce toxicity and limit development of further antimicrobial resistance. This topic should be included in general protocols on the management of Buruli ulcer.

Original languageEnglish
Article numbere2010
Number of pages8
JournalPLoS Neglected Tropical Diseases
Volume7
Issue number1
DOIs
Publication statusPublished - 24-Jan-2013

Keywords

  • MYCOBACTERIUM-ULCERANS
  • ANTIMICROBIAL PROPHYLAXIS
  • CARDIOVASCULAR-SURGERY
  • STAPHYLOCOCCUS-AUREUS
  • ESCHERICHIA-COLI
  • CARDIAC-SURGERY
  • HOSPITAL-CENTER
  • GHANA
  • RESISTANCE
  • STREPTOMYCIN

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