Saturday, January 01, 2011
Treatment is with parenteral penicillin 10-20 X 106 U/day for
For the penicillin-allergic patient, prescribe
sulfamethoxazole/trimethoprim DS (800/160) 3-5 tablets daily (2.4
to 4.0 g sulfamethoxazole daily).
- It is important to look for underlying bony involvement,
especially in the case of cervicofacial actinomycosis. Eradication
of an underlying dental source may enhance healing and prevent
relapse. Surgical intervention to drain and eradicate loculated and
scarred foci may be beneficial.
- After 2-4 weeks of parenteral penicillin, switch to oral
penicillin V 500 mg q.i.d. Continue therapy for at least 6 months
or until the lesion has been stable or has appeared healed for 3
months, whichever is longer.
- Failure to evaluate lesions by appropriate cultures and biopsy
often delays diagnosis.
- Premature termination of therapy often leads to
- Evaluate patient for immunosuppression, as immunocompetent
patients may require longer treatment courses.