Modified Welsh regimen: a promising therapy for actinomycetoma.
BACKGROUND
Mycetoma has a worldwide geographical distribution which is extremely uneven; however, it is a common disease in India and responsible for causing significant morbidity. Treatment of this condition is often a challenge for the treating dermatologist. The authors report a promising therapy for patients of actinomycotic mycetoma.


METHODS
This assessment series included 18 patients with a confirmed diagnosis of actinomycetoma, and who had shown a poor response to previous treatments. Patient received a combination therapy of the Welsh regimen (amikacin along with cotrimoxazole) to which rifampicin was added as a third drug. Clinical evaluation included radiology and laboratory investigations.


RESULTS
Sixteen patients out of 18 completed the combination therapy, which lead to remission. Two patients were lost to follow-up. Of the 16 patients in remission, no recurrence was observed during a follow-up period of up to 18 months.
Damle
D K
DK
Department of Dermatology, B.J. Medical College, Pune, Maharashtra State, India. drdkdamle@rediffmail.com
Mahajan
P M
PM
Pradhan
S N
SN
Belgaumkar
V A
VA
Gosavi
A P
AP
Tolat
S N
SN
Gokhale
N R
NR
Mhaske
C B
CB
D000328:Adult; D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008271:Mycetoma / Q000188:drug therapy* / Q000473:pathology; D011446:Prospective Studies; D012074:Remission Induction / Q000379:methods; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D000583:Amikacin; D012293:Rifampin