Drugs for treating Buruli ulcer (Mycobacterium ulcerans disease)

What was the aim of this review?

The aim of this Cochrane Review was to summarize the evidence for drug treatments for Buruli ulcer.

Key messages

Antibiotics are an important component of the treatment of Buruli ulcers, but there is no evidence to suggest that any particular drug is more effective than another.

What was studied in the review?

Buruli ulcer is a disease caused by mycobacterium (tuberculosis and leprosy are other types of diseases caused by mycobacterium), which results in lumps in the skin and deep ulcers, often on the arms or the face. When diagnosed late, those affected may be left with lifelong disfigurements and disabilities. The disease is most prevalent in West Africa, but it is also found in non‐tropical areas including Australia and Japan. It is often treated with drugs and surgery. This review compared different drug treatments for Buruli ulcer.

What are the main results of the review?

We included 18 studies from eight countries in West Africa and Australia (1984 participants). Antibiotic combination treatments evaluated appear to be effective, but the evidence is insufficient to show that any particular drug is more effective than another.

Testing treatments in Buruli ulcer is challenging as different sizes, lesions, and stages of the disease contribute to healing rates. Surgery also plays an important role in treating Buruli ulcer, and consequently, the independent effect of drugs is difficult to assess. Trials of new regimens that also address these factors will help to identify the best regimens.

How up‐to‐date is this review?

We searched for studies published up to 19 December 2017.