Antimicrobial Treatment of Mycobacterium ulcerans Infection

Immunity against Mycobacterium ulcerans: The subversive role of mycolactone

“…The WHO currently recommends an 8-week-long daily administration of oral rifampicin plus intramuscular streptomycin, associated with wound management and surgery for severe lesions. 13 While rare, mutations associated with drug resistance do occur 14 and require careful monitoring. Recently, Phillips et al reported that BU is curable by an all-oral, 8-week course of fully oral rifampicin plus clarithromycin with minimum use of surgery.…”

“…The WHO currently recommends an 8‐week‐long daily administration of oral rifampicin plus intramuscular streptomycin, associated with wound management and surgery for severe lesions 13 . While rare, mutations associated with drug resistance do occur 14 and require careful monitoring.…”

Beyond the approved: target sites and inhibitors of bacterial RNA polymerase from bacteria and fungi

“…142,164,165 However, it is not approved for the treatment of acute meningococcal infections due to the rapid emergence of resistant pathogens. It is also used for the treatment of diseases caused by several bacteria: leprosy ( M. leprae or M. lepromatosis ), 166–171 non-tuberculous mycobacterial pulmonary disease (NTM-PD; mycobacterial species other than the M. tuberculosis complex and those causing leprosy), 158,172–175 Buruli ulcer disease ( M. ulcerans ), 170,176–181 Legionnaires′ disease ( Legionella pneumophila ), 182–185 C. difficile , 151,186–191 and S. aureus infections, 192–197 to name a few. Some of the diseases treated with rifamycins are highlighted in Table 2.…”

Pharmacologic management ofMycobacterium ulceransinfection

“…A review [98] summarized the in vitro data; several different classes of antimicrobials including macrolides, rifamycins, aminoglycosides, fluoroquinolones, as well as an array of new classes of drugs appear to have potential to kill, or inhibit growth, of M. ulcerans. An assay that assesses the potential of agents to arrest mycolactone production alone, without inhibiting growth or killing M. ulcerans, has been profoundly challenging [99].…”