Is amoxicillin-clavulanate (Augmentin) effective against Corynebacterium ulcerans toxinogenic strains?

Amoxicillin-clavulanate can be considered for the treatment of Corynebacterium ulcerans infections, including toxinogenic strains, due to its broad-spectrum activity. However, it is crucial to approach this with caution and consider the severity of the disease and local resistance patterns. A typical regimen might include amoxicillin-clavulanate 875mg/125mg orally twice a day for 14 days. In severe cases or for patients who cannot tolerate oral medications, intravenous antibiotics such as penicillin G or a cephalosporin may be necessary. For patients with severe allergic reactions to penicillin, alternative treatments like azithromycin or clarithromycin could be considered as second-line options, although their efficacy against Corynebacterium ulcerans specifically may vary. It's also important to note that treatment should be guided by susceptibility testing when possible, and consultation with an infectious disease specialist may be beneficial in managing complex cases.