Table 4.
Therapeutic considerations for Actinomyces infections.
| Antibiotic Therapy | |
| Should be Considered | Should NOT be Considered |
| Penicillin G | Metronidazole * |
| Penicillin V | Aminoglycosides * |
| Ampicillin | Other β-lactam-β-lactamase-inhibitor combinations * |
| Amoxicillin | Penicillinase-stable penicillins |
| Piperacillin/tazobactam | First generation cephalosporins (cephalexin) |
| Second generation cephalosporins with anti-anaerobic activity (cefoxitin) | Aztreonam * |
| Third generation cephalosporins (ceftriaxone) | Sulfamethoxazole/trimethoprim * |
| Carbapenems | Fluoroquinolones * |
| Doxycycline | |
| Tigecycline | |
| Clindamycin | |
| Macrolides | |
| Chloramphenicol | |
| Adjunctive Therapy | |
| Surgical debridement, drainage | |
| Photodynamic therapy | |
| Laser therapy | |
* Should be reconsidered in case of polymicrobial infections (e.g., Enterobacteriaceae, other anaerobes).