This protocol addresses cervicofacial actinomycosis in patients with a known penicillin allergy, where an alternative antibiotic strategy is required.
Management combines a surgical approach — including drainage of the swelling and debridement of necrotic tissue when needed — with clindamycin as the antibiotic in this setting. The complete dosing regimen, schedule, and full clinical algorithm are available in the structured protocol.
The primary aim is clinical improvement. Time to response can vary considerably from patient to patient.
In case of penicillin allergy, clindamycin would be administered.
Sixteen (84.2%) patients were treated with intravenous antibiotics, incision and drainage of the swelling, and debridement of necrotic tissue, if needed.
Patients were discharged from hospital when clinical improvement was seen.
Time to clinical improvement ranged from 1 to 46 days (SD 8.4 ± 13.2) when treated with intravenous AB.
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