A two-step schedule for the treatment of actinomycotic mycetomas

Acta Derm Venereol. 2000 Sep-Oct;80(5):378-80. doi: 10.1080/000155500459367.

Abstract

Actinomycotic mycetomas usually respond slowly to treatment with antibiotics. In an attempt to hasten clinical resolution, we used a 2-step regimen consisting of an intensive phase of therapy with penicillin, gentamycin and co-trimoxazole for 5-7 weeks, followed by maintenance therapy with amoxicillin and co-trimoxazole. Seven patients were treated, all of whom showed significant reduction in discharge and swelling after the intensive phase. Maintenance therapy was continued for 2-5 months after the lesions became completely inactive. Five patients completed maintenance therapy, which was given for 6-16 months (mean 10.7 months), and remained free of disease during a mean post-treatment follow-up period of 6.4 months. The other 2 patients also responded satisfactorily and continue to receive maintenance therapy. Side-effects necessitating a modification of the treatment schedule occurred in 2 patients but reversed on discontinuation of the drugs responsible. This treatment schedule produces a rapid clinical response during the initial, intensive phase and promotes compliance with the longer maintenance phase of treatment necessary to achieve a complete cure.

MeSH terms

  • Actinomycosis / diagnosis
  • Actinomycosis / drug therapy*
  • Adolescent
  • Adult
  • Amoxicillin / therapeutic use
  • Drug Administration Schedule
  • Drug Therapy, Combination / therapeutic use*
  • Female
  • Gentamicins / therapeutic use
  • Humans
  • Long-Term Care
  • Male
  • Middle Aged
  • Mycetoma / diagnosis
  • Mycetoma / drug therapy*
  • Penicillins / therapeutic use
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Gentamicins
  • Penicillins
  • Amoxicillin
  • Trimethoprim, Sulfamethoxazole Drug Combination