This protocol addresses abdominal actinomycosis occurring alongside beta-lactamase-producing organisms in tissue and sample cultures — specifically in cases where the preceding treatment course did not achieve resolution of infection.
Actinomyces can grow with other organisms in tissue and sample cultures in a large proportion of cases. These co-organisms are typically anaerobic, originating from the oral flora, and they can produce beta-lactamases that undermine the antimicrobial activity directed at actinomyces.
The preceding line involved a combination of a beta-lactam plus beta-lactamase inhibitor, targeting resolution of actinomycosis infection over the expected course. This protocol applies when that primary goal — resolution of infection — was not achieved.
When infection has progressed or complicated, surgical intervention is among the approaches that may be warranted — though the full structured management plan is detailed in the protocol below.
DOI: 10.5772/intechopen.104698
As mentioned before, Actinomyces can grow with other organisms in tissue and sample cultures in almost 75 to 95% of cases.
The other organisms are usually anaerobic from the oral flora, and they can produce beta-lactamases that can protect actinomyces from penicillin.
When infection complicates with abscess and fistula formation, surgical management and drainage is warranted, especially in life threatening presentations.
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