Buruli ulcer

Treatment

Treatment consists of a combination of antibiotics and complementary treatments. Treatment guidance for health workers can be found in the WHO publication “Treatment of mycobacterium ulcerans disease (Buruli ulcer).”

Antibiotics

Different combination of antibiotics given for 8 weeks are used to treat the Buruli ulcer irrespective of the stage. One of the following combinations may be used depending on the patient:

  • a combination of rifampicin (10 mg/kg once daily) and streptomycin (15 mg/kg once daily); or
  • a combination of rifampicin (10 mg/kg once daily) and clarithromycin (7.5 mg/kg twice daily) has been used, though its effectiveness has not been proven by a randomized trial.

Since streptomycin is contraindicated in pregnancy, the combination of rifampicin and clarithromycin is considered the safer option for pregnant patients. A combination of rifampicin (10 mg/kg once daily) and moxifloxacin (400 mg once daily) has also been used though its effectiveness has not been proven by randomized trial.

Morbidity management, disability prevention and rehabilitation

Interventions such as wound management and surgery (mainly debridement and skin grafting) are used to speed up the healing of wounds, thereby working to prevent and rehabilitate disability.

Prevention

As there is no knowledge of how Buruli ulcer is transmitted, preventive measures cannot be applied.