Mild disease

For initial empirical therapy of nocardiosis in patients with mild disease (see Nocardiosis disease categories for treatment), use:

When susceptibility is known, continue therapy with trimethoprim+sulfamethoxazole or an alternative antimicrobial to which the organism is confirmed susceptible. The total duration of therapy is 3 months (including eradication), or longer if there is a slow response to therapy.

Unless the isolate is resistant, drug desensitisation is recommended for patients who are hypersensitive to trimethoprim+sulfamethoxazole—seek expert advice. If there is resistance to trimethoprim+sulfamethoxazole, or if the patient is hypersensitive and desensitisation cannot be performed, alternative options for therapy include amoxicillin+clavulanate, minocycline, linezolid or moxifloxacin, depending on susceptibility—seek expert advice.