title: Treatment of cutaneous actinomycosis with amoxicillin/clavulanic acid.
abstract: OBJECTIVE
  To evaluate the efficacy and tolerability of amoxicillin/clavulanic (AMX/CLV) acid as treatment for cutaneous actinomycosis.
  
  
  METHODS
  We present a long-term follow-up study of cutaneous actinomycosis patients. Cervicofacial (CFA) and abdominal (AA) were recruited during 6 years. Diagnoses were based on clinical and microbiological characteristics; presence of granules, isolation and identification of etiological agents were carried out in each case. Patients received AMX-CLV 875/125 mg BID PO at a maximum period of 12 weeks.
  
  
  RESULTS
  Twenty-two cases were enrolled; the mean age was 45.2 years old. Twenty patients (91%) presented CFA and two AA (9%). All patients with CFA had dental caries, seven (35%) with periodontal disease and 10 (50%) had type-2 diabetes mellitus (T2DM). One case of AA had history of intrauterine device and other appendicitis. Granules were observed in all the cases, the main etiological agent was Actinomyces israelii 16/22 (72.7%). Clinical and microbiological cure was achieved in 19/22 cases (86.4%), the remaining patients presented clinical improvement. The average duration of the treatment was 6.6 weeks. Side effects were recorded in 4/19 cases (18.2%), three of them presented nausea and one diarrhea.
  
  
  CONCLUSIONS
  Treatment with AMX/CLV acid showed efficacy in the management of actinomycosis with cutaneous involvement.
authors.affiliation: b Mycology Department , Hospital General de México, "Dr. Eduardo Liceaga" , Mexico City , Mexico.
authors.forename: Alexandro
authors.initials: A
authors.lastname: Bonifaz
authors.affiliation: a Dermatology Service , Hospital General de México, "Dr. Eduardo Liceaga" , Mexico City , Mexico.
authors.forename: Andrés
authors.initials: A
authors.lastname: Tirado-Sánchez
authors.affiliation: a Dermatology Service , Hospital General de México, "Dr. Eduardo Liceaga" , Mexico City , Mexico.
authors.forename: Luz
authors.initials: L
authors.lastname: Calderón
authors.affiliation: a Dermatology Service , Hospital General de México, "Dr. Eduardo Liceaga" , Mexico City , Mexico.
authors.forename: Griselda
authors.initials: G
authors.lastname: Montes de Oca
authors.affiliation: a Dermatology Service , Hospital General de México, "Dr. Eduardo Liceaga" , Mexico City , Mexico.
authors.forename: Paula
authors.initials: P
authors.lastname: Torres-Camacho
authors.affiliation: a Dermatology Service , Hospital General de México, "Dr. Eduardo Liceaga" , Mexico City , Mexico.
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Ponce
mesh_terms: D000196:Actinomycosis / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use*; D003731:Dental Caries / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D019980:Amoxicillin-Potassium Clavulanate Combination
keywords: Actinomyces israelii; abdominal; actinomycosis; amoxicillin–clavulanate; appendicitis; cervicofacial; dental caries; diabetes mellitus