Department of Oral and Maxillofacial Surgery, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherland.
Med Oral Patol Oral Cir Bucal. 2013 Jul 1;18(4):e627-32. doi: 10.4317/medoral.19124.
Actinomycosis is a chronic suppurative granulomatous infection caused by the Actinomyces genus. Orocervicofacial actinomycosis is the most common form of the disease, seen in up to 55% of cases. All forms of actinomycosis are treated with high doses of intravenous penicillin G over two to six weeks, followed by oral penicillin V. Large studies on cervicofacial actinomycosis are lacking. Therefore proper guidelines for treatment and treatment duration are difficult to establish. The aim of this study is to establish effective treatment and treatment duration for orocervicofacial actinomycosis.
A Pubmed and Embase search was performed with the focus on treatment and treatment duration for cervicofacial actinomycosis. The hospital records of all patients presenting to our department with head and neck infection from January 2000 to December 2010 were reviewed, retrospectively. The following data were collected: age, gender, clinical presentation, aetiology, duration of symptoms, microbiological findings, treatment, and duration of treatment. The treatment and treatment duration is subsequently compared to the literature.
The literature search provided 12 studies meeting the inclusion criteria. All studies were retrospective in nature. Penicillin or amoxicillin/clavulanic acid are the preferred antibiotic regimens found in the literature. Most of our patients were treated with a combination of penicillin G 12 million units/day and metronidazol 500 mg 3/day, most commonly for a duration of 1 - 4 weeks, being shorter than the 3 - 52 weeks reported in the literature.
When actinomycosis is suspected, our review has shown that a surgical approach in combination with intravenous penicillin and metronidazol until clinical improvement is seen, followed by oral antibiotics for 2 - 4 weeks is generally efficient.
放线菌病是由放线菌属引起的慢性化脓性肉芽肿感染。口咽面颈部放线菌病是最常见的疾病形式，约 55%的病例可见。所有形式的放线菌病均采用高剂量静脉注射青霉素 G 治疗 2 至 6 周，然后口服青霉素 V。关于面颈部放线菌病的大型研究很少。因此，难以制定适当的治疗和治疗持续时间的指南。本研究旨在确定口咽面颈部放线菌病的有效治疗和治疗持续时间。
对 Pubmed 和 Embase 进行了搜索，重点关注面颈部放线菌病的治疗和治疗持续时间。回顾性分析了 2000 年 1 月至 2010 年 12 月期间我院因头颈部感染就诊的所有患者的医院记录。收集的数据包括：年龄、性别、临床表现、病因、症状持续时间、微生物学发现、治疗和治疗持续时间。随后将治疗和治疗持续时间与文献进行比较。
文献搜索提供了符合纳入标准的 12 项研究。所有研究均为回顾性研究。青霉素或阿莫西林/克拉维酸是文献中首选的抗生素方案。我们的大多数患者接受青霉素 G 1200 万单位/天和甲硝唑 500mg 3/天的联合治疗，最常见的治疗时间为 1-4 周，短于文献报道的 3-52 周。
当怀疑放线菌病时，我们的回顾性研究表明，在出现临床改善之前，联合手术、静脉注射青霉素和甲硝唑治疗，然后口服抗生素 2-4 周通常是有效的。
