A modified two-step treatment for actinomycetoma.
Indian J Dermatol Venereol Leprol
;
2007 Jul-Aug; 73(4): 235-9
Article
in English
| IMSEAR
| ID: sea-52691
ABSTRACT
BACKGROUND:
Combination antibiotic regimens are effective in the treatment of actinomycetoma but many treatment schedules require supervised parenteral therapy for prolonged periods. We describe a schedule that includes parenteral medication in an initial, short phase followed by a longer phase of oral medication.METHODS:
Sixteen patients with clinically diagnosed mycetoma, who did not show any evidence of a fungal etiology, were treated presumptively for actinomycetoma. Evidence of actinomycotic infection was found on microscopy of granules / discharge and / or histopathological examination in eight (50%) patients. The treatment consisted of an intensive phase (Step 1) with gentamicin, 80 mg twice daily, intravenously and cotrimoxazole, 320/1600 mg twice daily orally for four weeks. This was followed by a maintenance phase with cotrimoxazole and doxycycline, 100 mg twice daily till all sinuses healed completely. The treatment was continued for 5-6 months.RESULTS:
Treatment response was assessed monthly. At the end of the intensive phase, there was a significant improvement in all 16 patients. Nine patients who continued the maintenance phase of the regimen had complete healing of sinuses with marked reductions in swelling and induration in 2.4 +/- 1.7 months. Maintenance treatment was continued for a mean of 9.1 +/- 4.3 months in these patients. Six patients have remained free of disease activity during a follow-up period of 11.1 +/- 4.2 months after treatment was stopped. Two patients developed leucopenia and thrombocytopenia necessitating withdrawal of cotrimoxazole.CONCLUSION:
This regimen was effective in treating actinomycetoma. The short duration of the phase requiring parenteral therapy makes it convenient to administer.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Aged
/
Actinomycosis
/
Female
/
Humans
/
Male
/
Drug Administration Schedule
/
Gentamicins
/
Trimethoprim, Sulfamethoxazole Drug Combination
/
Adolescent
/
Skin Diseases, Bacterial
Language:
English
Journal:
Indian J Dermatol Venereol Leprol
Year:
2007
Type:
Article
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