01708nas a2200277   4500000000100000008004100001653001200042653001700054653001500071653001700086653001100103100001500114700001200129700001200141700001300153700001300166700001300179700001300192700001500205700001300220700002300233245019500256300001400451490000700465520095800472       2014                            d10aWestern10aStreptomyces10aRifampicin10aBuruli ulcer10aAfrica1 aPhillips R1 aSarfo F1 aAbass M1 aAbotsi J1 aWilson T1 aForson M1 aAmoaho Y1 aThompson W1 aAsiedu K1 aWansbrough-Jones M00aClinical and bacteriological efficacy of Rifampin-Streptomycin combination for two weeks followed by Rifampin and Clarithromycin for six weeks for treatment of mycobacterium ulcerans disease  a1161-11660 v583 aBuruli ulcer, an ulcerating skin disease caused by Mycobacterium ulcerans infection, is common in tropical areas of western Africa. We determined the clinical and microbiological responses to administration of rifampin and streptomycin for 2 weeks followed by administration of rifampin and clarithromycin for 6 weeks in 43 patients with small laboratory-confirmed Buruli lesions and monitored for recurrence-free healing. Bacterial load in tissue samples before and after treatment for 6 and 12 weeks was monitored by semiquantitative culture. The success rate was 93%, and there was no recurrence after a 12-month follow-up. Eight percent had a positive culture 4 weeks after antibiotic treatment, but their lesions went on to heal. The findings indicate that rifampin and clarithromycin can replace rifampin and streptomycin for the continuation phase after rifampin and streptomycin administration for 2 weeks without any apparent loss of efficacy.