Discussion
The treatment of actinomycosis is
Answer: B
Correct answer: Prolonged high-dose penicillin, often for several months
Actinomyces is fully sensitive to penicillin, but the lesion is a dense fibrotic mass with poor blood supply through which the drug penetrates badly, so treatment must be given in high dose and continued for weeks to months - conventionally intravenous penicillin followed by several months of oral therapy - with surgical drainage of any collection. A short course relapses. Metronidazole is inactive against Actinomyces, and amphotericin B is irrelevant, since the organism is a bacterium and not a fungus despite its fungus-like growth.
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