Although almost all of the 84 surgical patients admitted to the University of Kentucky (UK) HealthCare with an Actinomyces species infection received antibiotic therapy once the infection had been discovered, some did not receive appropriate antibiotics at discharge, according to a presentation at the Critical Care Congress 2026, in Chicago.
The study began after a quality improvement initiative at Lexington-based UK HealthCare showed an increase in Actinomyces infections.
“There were some patients who had more than one readmission,” noted Ann Margaret Routon, PharmD, a PGY-2 critical care pharmacy resident who presented UK HealthCare’s analysis.
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Standard therapy for an Actinomyces infection—which can cause dense fibrotic tissue in the digestive, respiratory, and urogenital tracts—includes high-dose penicillin, first given intravenously for four to six weeks and then continued orally with penicillin G or Amoxicillin/17602" target="_blank">amoxicillin for six to 12 months. At UK HealthCare 54.2% of the antibiotics prescribed at discharge were aminopenicillins, which are also effective broad-spectrum antibiotics against the anaerobic, gram-positive Actinomyces.
At the index encounter, 80 of 84 patients (95%) received appropriate antibiotics against Actinomyces, Dr. Routon reported. At discharge this had dropped to 68 of 84 patients (81%).
Even though the overall readmission rate was low, Dr. Routon noted that many patients were lost to follow-up. UK HealthCare is a referral center for the state of Kentucky, but once people return to their communities, it can be hard to know how they are doing. Infectious disease follow-up consultations were scheduled for 33% of the 84 patients at discharge, and 48% of people attended these appointments.
Thirty patients reported a gap in antibiotic therapy at discharge; the median gap was 35 days (IQR, 19.3-52.8). “This inappropriate therapy and duration lead to the need for institutional protocols and improved outpatient follow up in managing Actinomyces infections,” Dr. Routon and colleagues concluded.
Dr. Routon reported no relevant financial disclosures.