title: A two-step schedule for the treatment of actinomycotic mycetomas.
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.
authors.affiliation: Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi. mramam@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Ramam
authors.forename: T
authors.initials: T
authors.lastname: Garg
authors.forename: P
authors.initials: P
authors.lastname: D'Souza
authors.forename: K K
authors.initials: KK
authors.lastname: Verma
authors.forename: B K
authors.initials: BK
authors.lastname: Khaitan
authors.forename: M K
authors.initials: MK
authors.lastname: Singh
authors.forename: U
authors.initials: U
authors.lastname: Banerjee
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D008271:Mycetoma / Q000175:diagnosis / Q000188:drug therapy*; D010406:Penicillins / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D005839:Gentamicins; D010406:Penicillins; D000658:Amoxicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination