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Management of Mycobacterium ulcerans infection in a pregnant woman in Benin using rifampicin and clarithromycin

Ange D Dossou, Ghislain E Sopoh, Christian R Johnson, Yves T Barogui, Dissou Affolabi, Sévérin Y Anagonou, Théophile Zohoun, Françoise Portaels and Kingsley Asiedu
Med J Aust 2008; 189 (9): . || doi: 10.5694/j.1326-5377.2008.tb02166.x
Published online: 3 November 2008

To the Editor: Buruli ulcer, caused by the bacterium Mycobacterium ulcerans, leads to the destruction of skin and sometimes bone. It has been reported in many tropical countries in Africa and in some temperate regions of Australia, Japan and China.1 In 2004, the World Health Organization recommended treatment with the combination of oral rifampicin and intramuscular streptomycin (or amikacin) for 8 weeks.2,3 In-vitro studies and new data from mouse models suggest that combinations of rifampicin with clarithromycin, rifampicin with moxifloxacin, or clarithromycin with moxifloxacin may be as effective as rifampicin and streptomycin.4,5


  • 1 Centre de Dépistage et de Traitemente de l’Ulcère, Allada, Benin.
  • 2 Programme National de Lutte contre la Lépre et l’Ulcère de Buruli, Cotonou, Benin.
  • 3 Centre de Dépistage et de Traitemente de l’Ulcère, Lalo, Benin.
  • 4 Laboratoire de Référence des Mycobactéries, Cotonou, Benin.
  • 5 Faculté des Sciences de la Santé, Cotonou, Benin.
  • 6 Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium.
  • 7 Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.


Correspondence: cdtuballada@yahoo.fr

Acknowledgements: 

Fondation Luxembourgeoise Raoul Follereau, Luxembourg; Projet Burulico European Union (project reference number, INCO-CT-2005-051476); and the World Health Organization, Geneva.

  • 1. Portaels F, Johnson P, Meyers WM, editors. Buruli ulcer. Diagnosis of Mycobacterium ulcerans disease. A manual for health care providers. Geneva: World Health Organization, 2001: 92.
  • 2. World Health Organization. Provisional guidance on the role of specific antibiotics in the management of Mycobacterium ulcerans disease (Buruli ulcer). Geneva: WHO/CDS/CPE/GBUI.10, 2004. http://www.who.int/buruli/information/antibiotics/en/index.html (accessed 2004).
  • 3. Johnson PDR, Hayman JA, Quek TY, et al. Consensus recommendations for the diagnosis, treatment and control of Mycobacterium ulcerans infection (Bairnsdale or Buruli ulcer) in Victoria, Australia. Med J Aust 2007; 186: 64-68. <MJA full text>
  • 4. Portaels F, Traore H, De Ridder K, Meyers WM. In vitro susceptibility of Mycobacterium ulcerans to clarithromycin. Antimicrob Agents Chemother 1998; 42: 2070-2073.
  • 5. Ji B, Chauffour A, Robert J, et al. Orally administered combined regimens for treatment of Mycobacterium ulcerans infection in mice. Antimicrob Agents Chemother 2007; 51: 3737-3739.

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