Medical Care: In most cases, antimicrobial therapy is the only treatment required, although surgery can be an adjunct in selected cases. Penicillin G is the drug of choice for treating an infection caused by actinomycetes.
High-dose penicillin, administered over a prolonged period, is the cornerstone of therapy for actinomycosis. The risk of actinomycetes developing penicillin resistance appears to be minimal. Lack of a clinical response to penicillin usually indicates the presence of resistant companion bacteria, which may require modification of the antibiotic regimen (ie, addition of an agent that is active against these copathogens).
Antibiotics that possess no activity against Actinomyces species include metronidazole, aminoglycosides, aztreonam, co-trimoxazole (TMP-SMX), and penicillinase-resistant penicillins (eg, methicillin, nafcillin, oxacillin, cloxacillin) and cephalexin. The data concerning the fluoroquinolones (ciprofloxacin, gatifloxacin and moxifloxacin) are insufficient
Surgical Care: Attempt to cure actinomycosis, including extensive disease, with aggressive antimicrobial therapy alone initially. Surgical therapy may include incision and drainage of abscesses, excision of sinus tracts and recalcitrant fibrotic lesions, decompression of closed-space infections, and interventions aimed at relieving obstruction (eg, when actinomycotic lesions compress the ureter).
MEDICATION :
1. PENICILLIN G
2. PENICILLIN K
3. DOXYCYCLINE : 100 MG TWICE DAILY
4. CLINDAMYCIN
5. AMOXYCILLIN+CLAVULANIC ACID
6. CEFTRIAXONE
7. IMIPENEM/CILASTATIN