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Cervicofacial Actinomycosis — SCE Infectious Diseases MCQ

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ModerateTropical & Imported InfectionsCervicofacial ActinomycosisSCE Infectious Diseases

A 30-year-old man presents with a chronic discharging sinus over his right mandible. He has received multiple courses of oral antibiotics without improvement. Actinomyces israelii is isolated from deep tissue samples. He is started on IV Benzylpenicillin. After 4 weeks of IV therapy, what is the recommended duration of subsequent oral therapy?

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Correct answer: B — Oral Amoxicillin for a total treatment duration of 6–12 months

Cervicofacial actinomycosis requires prolonged antibiotic therapy to prevent relapse due to the organism's ability to form abscesses and cross tissue planes. After an initial IV phase (2–6 weeks of IV Benzylpenicillin or Amoxicillin), oral step-down to Amoxicillin 500 mg TDS should continue for a total treatment duration of 6–12 months. Some experts use shorter courses (3 months) if surgical debridement has been thorough. Penicillin is the antibiotic of choice; Doxycycline is an alternative for penicillin allergy.

Reference: BSAC 2017 – Actinomycosis; BNF 2024 – Actinomycosis treatment