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Pediatric Actinomycosis Medication

  • Author: Jorge M Quinonez, MD; Chief Editor: Russell W Steele, MD  more...
 
Updated: Jan 12, 2016
 
 

Antibiotics

Class Summary

For most complicated cases, 4-6 wk of intravenous penicillin G followed by 6-12 months of oral penicillin V is indicated. For patients with penicillin allergy, clindamycin, ceftriaxone, chloramphenicol, and tetracyclines are good alternatives. Parenteral and oral combinations of these drugs have been successful. Because co-infection with A actinomycetemcomitans is common, covering for this organism when present is important, especially in patients who are critically ill. Actinomycosis is susceptible to third-generation cephalosporins, rifampin, trimethoprim-sulfamethoxazole, ciprofloxacin, tetracyclines, and chloramphenicol.

Penicillin G (Pfizerpen)

 

First-line drug. Used for IV courses of 4-6 wk. Interferes with synthesis of cell wall mucopeptide during active multiplication, resulting in bactericidal activity against susceptible microorganisms.

Penicillin VK (Beepen-VK, Betapen-VK, Pen-Vee K)

 

First-line drug to be used as follow-up on previous parenteral therapy.

Clindamycin (Cleocin)

 

Second-line drug. Inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest.

Chloramphenicol (Chloromycetin)

 

Second-line drug. The PO form is unavailable in the United States. Only use when no other alternatives are available. Binds to 50S bacterial-ribosomal subunits and inhibits bacterial growth by inhibiting protein synthesis.

Ceftriaxone (Rocephin)

 

Second-line drug. Arrests bacterial growth by binding to one or more penicillin binding proteins.

Tetracycline HCl (Sumycin)

 

Second-line drug. Inhibits bacterial protein synthesis by binding with 30S and possibly 50S ribosomal subunit(s).

 
 
Contributor Information and Disclosures
Author

Jorge M Quinonez, MD Senior Vice President and Chief Medical Officer, Family Health Centers of Southwest Florida, Inc

Jorge M Quinonez, MD is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America

Disclosure: Received consulting fee from Glaxo Smith Kline for speaking and teaching.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Mark R Schleiss, MD Minnesota American Legion and Auxiliary Heart Research Foundation Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School

Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Itzhak Brook, MD, MSc Professor, Department of Pediatrics, Georgetown University School of Medicine

Itzhak Brook, MD, MSc is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, Association of Military Surgeons of the US, Infectious Diseases Society of America, International Immunocompromised Host Society, International Society for Infectious Diseases, Medical Society of the District of Columbia, New York Academy of Sciences, Pediatric Infectious Diseases Society, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, Society for Ear, Nose and Throat Advances in Children, American Federation for Clinical Research, Surgical Infection Society, Armed Forces Infectious Diseases Society

Disclosure: Nothing to disclose.

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