Although the susceptibility patterns of aerobic actinomycetes vary considerably, the following "typical" drugs of choice/profiles have been reported in the literature:41
- Nocardia: For many species, sulfa-containing drugs remain the drug of choice. Nocardia species vary widely in their susceptibility patterns, and some are multidrug-resistant.
- Streptomyces: Sulfa-containing drugs, streptomycin
- Rhodococcus: Usually susceptible to erythromycin, aminoglycosides, extended-spectrum macrolides, fluoroquinolones, glycopeptides, and imipenem. Resistance may be a problem with sulfa drugs.
- Gordonia: Usually susceptible to ampicillin, macrolides, quinolones, and cephalosporins
- Actinomadura: Sulfa-containing drugs, streptomycin
- Tsukamurella: Susceptible to amikacin, sulfa drugs, quinolones, and clarithromycin. Note: There is no standardized regimen for treatment.
- Williamsia: Usually resistant to sulfa drugs, but susceptible to ampicillin/clavulanate, quinolones, aminoglycosides, vancomycin
Susceptibility testing of isolates is recommended due to the high variability of patterns among these organisms.
41. Mochon, A. B., Sussland, D., & Saubolle, M. A. (2016). Aerobic Actinomycetes of Clinical Significance. Microbiology spectrum, 4(4), 10.1128/microbiolspec.DMIH2-0021-2015. https://doi.org/10.1128/microbiolspec.DMIH2-0021-2015
