Modifi ed Welsh Regimen: A Promising Therapy for Actinomycetoma

September 2008 | Volume 7 | Issue 9 | Original Article | 853 | Copyright © September 2008

D. K. Damle MD DNB, P. M. Mahajan MD, S. N. Pradhan MD, V. A. Belgaumkar MD, A. P. Gosavi MD, S. N. Tolat MD, N. R. Gokhale MD, C. B. Mhaske MD

Abstract
Background: Mycetoma has a worldwide geographical distribution which is extremely uneven; however, it is a common disease in India and responsible for causing signifi cant morbidity. Treatment of this condition is often a challenge for the treating dermatologist. The authors report a promising therapy for patients of actinomycotic mycetoma.
Methods: This assessment series included 18 patients with a confi rmed diagnosis of actinomycetoma, and who had shown a poor response to previous treatments. Patient received a combination therapy of the Welsh regimen (amikacin along with cotrimoxazole) to which rifampicin was added as a third drug. Clinical evaluation included radiology and laboratory investigations.
Results: Sixteen patients out of 18 completed the combination therapy, which lead to remission. Two patients were lost to follow-up. Of the 16 patients in remission, no recurrence was observed during a follow-up period of up to 18 months.