Modified Welsh regimen: a promising therapy for actinomycetoma.

BACKGROUND: Mycetoma has a worldwide geographical distribution which is extremely uneven; however, it is a common disease in India and responsible for causing significant 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 confirmed 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.