Towards rational use of antibiotics for suspected secondary infections in Buruli ulcer patients.
PLoS Negl Trop Dis
; 7(1): e2010, 2013.
Article
in En
| MEDLINE
| ID: mdl-23359827
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/PRINCIPALFINDINGS:
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 Bénin 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 Bénin, 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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bacterial Infections
/
Wound Infection
/
Drug Utilization
/
Buruli Ulcer
/
Anti-Bacterial Agents
Type of study:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
Africa
Language:
En
Journal:
PLoS Negl Trop Dis
Journal subject:
MEDICINA TROPICAL
Year:
2013
Document type:
Article
Affiliation country:
Netherlands