How might nocardiosis be treated?

Nocardiosis is typically treated with the use of antibiotics. Because some Nocardia species are resistant to certain antibiotics, laboratory testing is needed to find out which species is causing the infection and to which antibiotic these bacteria may be susceptible. Treatment usually lasts for at least six months and may involve use of more than one antibiotic, but depending on the severity may last for about a year. Some abscesses or wound infections may need to be surgically drained.

The antibiotic known as trimethoprim-sulfamethoxazole (TMP-SMZ) is considered the therapy of choice by most doctors. Other antibiotics include:

  • Sulfonamides
  • Carbapenems (imipenem or meropenem, but not ertapenem)
  • Third-generation cephalosporins (cefotaxime or ceftriaxone), and amikacin, alone or in combination.
  • Imipenem plus amikacin (which may be the chosen treatment for patients with sulfonamide-allergic patients)
  • Linezolid
  • Tigecycline
  • Combination therapy with several antibiotics

Other alternative oral treatment include minocycline and amoxicillin/clavulanate, in addition to linezolid.

Last updated on 05-01-20

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