Shorter, safer treatment for Buruli ulcer on trial

A world-first clinical trial, conducted by Barwon Health’s Infectious Disease Unit, is hoping to reduce the time required to treat Buruli ulcer.

Buruli ulcer is a skin disease caused by the bacterium Mycobacterium ulcerans.

The toxins made by the bacteria destroy skin cells, small blood vessels and the fat under the skin, leading to ulceration and skin loss, which is why Buruli ulcer has earned a reputation as a “flesh-eating” disease.

Discovered earlier this year to be spread via mosquitoes that have become infected after biting possums carrying the bacteria, Buruli ulcer can lead to significant and long-standing physical and psychological illness, resulting in considerable costs to both patients and the community.

While the overall risk of infection is still considered low, the number of people affected by Buruli ulcer across the community is on the rise, as the disease continues to spread within the suburbs of Geelong, the Bellarine Peninsula and the Surf Coast.

At present, Buruli ulcers require up to eight weeks of treatment and a combination of dual antibiotic therapy.

The trial, testing the effectiveness of a new antibiotic called Telacebec in treating the disease, hopes to change this.

Professor Daniel O’Brien, the director of Barwon Health’s infectious disease department, said a successful clinical trial will make a big difference to how clinicians currently treat Buruli ulcer patients.

“Current antibiotic treatment is long, requires two different antibiotics, has a high incidence of side effects and may cause serious interactions with people’s other medications,” he said.

“Additionally, even with antibiotics, ulcers take many months to heal, requiring costly dressings, regular medical reviews and significant time and inconvenience for the patients.

“Through this clinical trial, which is supported by the World Health Organisation, the aim is for Buruli ulcer treatment to be significantly shorter (reduced to two-four weeks), require only one antibiotic, be safer and more tolerable and result in significantly shorted healing times for BU lesions.

“It is hoped through our study that the use of Telacebec treatment will become the world recognised standard treatment for Buruli ulcer and also lead to improvements in treatment for Tuberculosis and Leprosy.”

Queenscliff resident Geoffrey Mutton is one of the patients eager to see the trial succeed.

Mr Mutton has been treated by Barwon Health since he was first diagnosed with a Buruli ulcer in May, but side effects from the current medication treatment have resulted in liver issues and interference with some of his other medications.

Even then, his wounds will take many months yet to heal.

“From a tiny wound that looked like an insect bite, to a large 50 cent coin sized wound in just a couple of weeks, seven weeks of antibiotics and acute inflammation of my foot, I was totally unprepared for the debilitating and painful effects of having a Buruli ulcer,” he said.

“Any successful trial of an alternative antibiotic that reduced likelihood of side effects and sped up the healing process would be very welcome for patients unfortunate to have been infected.”

Barwon Health is recruiting trial participants and is inviting those diagnosed with Buruli ulcer interested in being treated with the new antibiotic to ask their doctor for a referral to the health care provider’s Infectious Diseases Service or phone the Adrian Costa Clinical Trials Centre on 4215 2878 for more information.