Although the susceptibility patterns of aerobic actinomycetes vary considerably, the following "typical" drugs of choice/profiles have been reported in the literature65:
- 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.
65. Mochon AB, Sussland D, Saubolle MA. Aerobic actinomycetes of clinical significance. Microbiol Spectr. 2016;4(4):10.1128/microbiolspec.DMIH2-0021-2015. doi:10.1128/microbiolspec.DMIH2-0021-2015
