Table 1. In vitro susceptibility, clinical efficacy, and dose of current antibiotics for actinomycetoma and antifungal agents against M. mycetomatis.

Antibiotics	In vitro	Human infection	Dose
Sulfonamides DDS (4,4 diaminodiphenyl-sulfone)	No data	Effective	100–200 mg/day single dose
Trimethoprim-Sulfamethoxazole (TS)	Active	Effective	8 mg/40 mg
Amikacin sulphate-TS	Active	Effective	Amikacin: 15 mg kg/day IM or IV in two daily doses; TS as above
Netilmicin-TS	Active	Effective	Netilmicin 300 mg/day IM single dose; TS as above
Minocycline	Active	Effective in 70%	200 mg/day PO in divided dose
Amoxicillin-clavulanate	Active	Effective	500 mg/125 mg PO; tid for 3 to 6 months
Linezolid	Active	Effective	600 mg PO twice daily
Fosfomycin	Active	Effective	100–200 mg/kg/day q6-8 h IV or PO in 21-day cycles.
Imipenem	Active depending on the strain	Effective depending on the strain	500 mg IV q8 hours; not to exceed 50 mg/kg/day or 4 g/day
Meropenem	Active	Effective	500 mg IV q8 hr; not to exceed 2 g IV daily
Rifampicin	Active depending on the strain	Effective depending on the strain	10 mg/kg/day PO
Moxifloxacin	Active	Effective	400 mg/day IV or PO
Antifungal agents
Amphotericin B	Moderate activity	Not effective
Fluconazole	Limited activity	Not effective
Ketoconazole	Active	Variable efficacy	400–800 mg
Itraconazole	Active	Variable efficacy	200–400 mg
Voriconazole	Active	Effective in few case reports	200 mg
Posaconazole	Active	Effective in few cases
Isavuconazole	Active	No data
Echinocandins	Not active	No data
Terbinafine	Moderate activity	No data

Possible drug interactions, history of drug allergies, and co-morbidities should be analyzed in all drugs.

IM, intramuscularly; IV, intravenous; PO, orally; tid, three times daily.