Rifampicin and clarithromycin (extended release) versus rifampicin and streptomycin for limited Buruli ulcer lesions: a randomised, open-label, non-inferiority phase 3 trial

by Phillips RO, Robert J, Abass KM, Thompson W, Sarfo FW, Wilson T, Sarpong G, Gateau T, Chauty A, Omollo R, Ochieng Otieno M, Egondi TW, Ampadu EO, Agossadou D, Marion E, Ganlonon L, Wansbrough-Jones M, Grosset J, Macdonald JM, Treadwell T, Saunderson P, Paintsil A, Lehman L, Frimpong M, Sarpong NF, Saizonou R, Tiendrebeogo A, Ohene SA, Stienstra Y, Asiedu KB, van der Werf TS, on behalf of the study team. The Lancet 2020, doi: 10.1016/S0140-6736(20)30047-7

Summary: Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans that damages the skin and subcutis. Standard antimicrobial treatment involves painful and potentially harmful injections. The authors compared the efficacy and tolerability of the standard treatment with a fully oral treatment that uses an extended release formulation. They found that the fully oral regimen was non-inferior to the standard treatment for treatment of early, limited Buruli ulcer and that it was associated with fewer adverse events. The authors propose that the fully oral treatment be the preferred therapy for early, limited lesions of Buruli ulcer.

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