Table 3.

Various Treatment Regimes Used in Actinomycetoma

Regimen	Year	Intensive Phase	Maintenance Phase
1. Welsh regimen		Amikacin 15 mg/kg IM divided into two doses + sulfamethoxazole (35 mg/kg/day) and trimethoprim (7 mg/kg/day) divided into three doses for 21 days. (1–3 such cycles at 15‐day intervals)	Trimethoprim and sulfamethoxazole (7 and 35 mg/kg/day, respectively) continuing for 2 weeks after the last cycle
2. Modified Welsh regimen	2008	Amikacin 15 mg/kg/day in two divided doses + sulfamethoxazole–trimethoprim tablets (35 + 7 mg/kg/day) + capsule rifampicin 10 mg/kg/day for 21 days; 1–3 cycles at 15 day intervals	Sulfamethoxazole–trimethoprim tablets (35 + 7 mg/kg/day) + capsule rifampicin 10 mg/kg/day for 3 months
3. Two step regimen (Ramam regime)	2000	Crystalline penicillin 1 MU IV every 6 h + gentamicin 80 mg IV every 12 h + cotrimoxazole (trimethoprim–sulfamethoxazole 80/400 mg tablets; two tablets twice daily for 5–7 weeks)	Cotrimoxazole (80/400 mg), two tablets twice daily + amoxicillin tablets, 500 mg thrice daily for 2–5 months after the disease becomes inactive
4. Modified two-step regimen	2007	Gentamicin (80 mg twice daily, IV), and cotrimoxazole (two tablets of 960 mg twice daily) for 4 weeks	Doxycycline (100 mg orally, twice daily), and cotrimoxazole (two tablets of 960 mg twice daily), until 5–6 months after complete healing of all sinuses.

Note: Data from Relhan et al.¹