For cutaneous and subcutaneous infections
Treatment of human actinomycetes infections includes removal of the foreign body and drainage of the wound. Surgical debridement may be indicated. Wound care with a proper course of antibiotics is usually warranted.
CDC has reported that some Nocardia species are reported to have species-specific susceptibility profiles, but multidrug-resistant strains are common. Because of this, antimicrobial susceptibility testing (AST) should be performed on every isolate of clinical significance. In addition, "N. farcinica is often resistant to multiple antimicrobial agents, including trimethoprim-sulfamethoxazole (TMP-SMX)."42 (Of note, trimethoprim-sulfamethoxazole [TMP-SMX] treatment for HIV-infected patients may become quite complicated.)
Treatment for pulmonary and disseminated infections
Treatment of human pulmonary or disseminated infections is more difficult. They require proper antimicrobial therapy, which often lasts months or years if the patient does not succumb to the infection first. Surgical drainage of abscesses or lesions is often required.
