Pediatric Actinomycosis Medication

  • Author: Jorge M Quinonez, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Nov 28, 2011
 

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.

View full drug information

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.

View full drug information

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

 

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

View full drug information

Clindamycin (Cleocin)

 

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

View full drug information

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.

View full drug information

Ceftriaxone (Rocephin)

 

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

View full drug information

Tetracycline HCl (Sumycin)

 

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

Proceed to Follow-up
 
 
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 and Infectious Diseases Society of America

Disclosure: Glaxo Smith Kline Consulting fee Speaking and teaching

Specialty Editor Board

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 Federation for Clinical Research, American Medical Association, American Society for Microbiology, Armed Forces Infectious Diseases Society, 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 Ear, Nose and Throat Advances in Children, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, and Surgical Infection Society

Disclosure: Nothing to disclose.

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  American Legion 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, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

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, and Southern Medical Association

Disclosure: Nothing to disclose.

References

  1. Funke G, von Graevenitz A. Infections due to Actinomyces neuii (former "CDC coryneform group 1" bacteria). Infection. Mar-Apr 1995;23(2):73-5. [Medline].

  2. Siqueira JF, Rocas IN. Polymerase chain reaction detection of Propionibacterium propionicus and Actynomyces radicidentis in primary and persistent endodontic infections. Oral Surg oral Med Oral Pathol Oral Radiol Endod. 2003;96:215-222. [Medline].

  3. Perlow JH, Wigton T, Yordan EL, et al. Disseminated pelvic actinomycosis presenting as metastatic carcinoma: association with the progestasert intrauterine device. Rev Infect Dis. Nov-Dec 1991;13(6):1115-9. [Medline].

  4. Kutluhan A, Salviz M, Yalçiner G, Kandemir O, Yesil C. The role of the actinomyces in obstructive tonsillar hypertrophy and recurrent tonsillitis in pediatric population. Int J Pediatr Otorhinolaryngol. Mar 2011;75(3):391-4. [Medline].

  5. Liu V, Val S, Kang K, Velcek F. Case report: actinomycosis of the appendix--an unusual cause of acute appendicitis in children. J Pediatr Surg. Oct 2010;45(10):2050-2. [Medline].

  6. Cintron JR, Del Pino A, Duarte B, et al. Abdominal actinomycosis. Dis Colon Rectum. Jan 1996;39(1):105-8. [Medline].

  7. Henderson SR. Pelvic actinomycosis associated with an intrauterine device. Obstet Gynecol. May 1973;41(5):726-32. [Medline].

  8. Koshi G, Lalitha MK, Samraj T, et al. Brain abscess and other protean manifestations of actinomycosis. Am J Trop Med Hyg. Jan 1981;30(1):139-44. [Medline].

  9. Maxon S, Jacobs R. Actinomycosis. In: Feigin R, Cherry J, Fletcher J, eds. Textbook of Pediatric Infectious Diseases. Philadelphia, Pa: WB Saunders and Co; 1998:1587-90.

  10. Robinson JL, Vaudry WL, Dobrovolsky W. Actinomycosis presenting as osteomyelitis in the pediatric population. Pediatr Infect Dis J. Apr 2005;24(4):365-9. [Medline].

  11. Russo T. Agents of Actinomycosis. In: Mandell G, Bennett J, Dolin R, eds. Principles and Practice of Infectious Diseases. 4th ed. New York, NY: Churchill Livingston; 1995:2280-8.

  12. Sakallioglu U, Acikgoz G, Kirtiloglu T, et al. Rare lesions of the oral cavity: case report of an actinomycotic lesion limited to the gingiva. J Oral Sci. Mar 2003;45(1):39-42. [Medline].

  13. Skoutelis A, Petrochilos J, Bassaris H. Successful treatment of thoracic actinomycosis with ceftriaxone. Clin Infect Dis. Jul 1994;19(1):161-2. [Medline].

  14. Smego RA Jr. Actinomycosis of the central nervous system. Rev Infect Dis. Sep-Oct 1987;9(5):855-65. [Medline].

  15. Smego RA Jr, Foglia G. Actinomycosis. Clin Infect Dis. Jun 1998;26(6):1255-61; quiz 1262-3. [Medline].

  16. Snape PS. Thoracic actinomycosis: an unusual childhood infection. South Med J. Feb 1993;86(2):222-4. [Medline].

  17. Tanaka-Bandoh K, Watanabe K, Kato N, et al. Susceptibilities of Actinomyces species and Propionibacterium propionicus to antimicrobial agents. Clin Infect Dis. Sep 1997;25 Suppl 2:S262-3. [Medline].

  18. Weese WC, Smith IM. A study of 57 cases of actinomycosis over a 36-year period. A diagnostic 'failure' with good prognosis after treatment. Arch Intern Med. Dec 1975;135(12):1562-8. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.