Efficacy of imipenem therapy for Nocardia actinomycetomas refractory to sulfonamides

Nocardia beijingensis pulmonary infection successfully treated with intravenous beta-lactam antibiotics and oral minocycline

“…Beta-lactam antibiotics such as amoxicillin clavulanate, cefotaxime, and imipenem have been reported to be effective against selected Nocardia species. Although clinical data are limited, there have been few case reports of treatment failure by beta-lactams so long as they are effective in vitro [4,5,11,13,15,17,21,23]. Our case indicates that beta-lactam therapy might be effective so long as the isolate is susceptible to the antibiotic in vitro and the disease is mild to moderate.…”

“…SXT has been known to be protective against nocardiosis if it is administered as a prophylaxis; however, the protective effect has not been made clear [19][20][21]. In addition, there has been an increasing number of treatment failures with SXT [4,5,22]. Beta-lactam antibiotics such as amoxicillin clavulanate, cefotaxime, and imipenem have been reported to be effective against selected Nocardia species.…”

“…Trimethoprim-sulfamethoxazole (SXT) has been chosen as one of the first-line antibiotics; however, it may cause various side effects, especially in immunocompromised patients such as those with acquired immunodeficiency syndrome (AIDS) and renal transplant patients [1][2][3]. What makes the situation worse is that an increasing number of treatment failures with SXT has been reported [4,5].…”

A Fibrous Cavity in an Immunocompromised Lung: Nocardiosis Masquerading as Tuberculosis

“…Hence, the diagnosis may be delayed if the clinician and the microbiologist do not suspect the disease [2]. We hereby present a case of pulmonary nocardiosis that mimicked pulmonary TB in a patient with pre-morbidities of liver cirrhosis and membrano-proliferative glomerulonephritis on long-term glucocorticoid therapy.…”

“…The first line therapy that is usually used is the trimethoprimsulfamethoxazole combination. However, in severe infections, empirical therapy with 2-3 drugs should be started [2]. Treatment should ideally be for 1 year in immunocompromised individuals.…”