{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:46:32Z","timestamp":1790210792627,"version":"4.1.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"23","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Actinomyces europaeus and Clostridium innocuum are rare causes of necrotizing fasciitis. For both organisms, it is necessary to know the specific species because variations in antibiotic sensitivity exist, making treatment challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>An 86-year-old white female presented to the emergency department with severe pain in her right thigh. A computed tomography scan showed pockets of gas and edema in the subcutaneous tissue extending from the right lateral hemipelvis to the right inguinal area and proximal thigh. Her LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score was 7. The patient was started on intravenous vancomycin, piperacillin\/tazobactam, and clindamycin and brought to the operating room for debridement. Anaerobic cultures grew Bacteroides fragilis, Bacteroides uniformis, and C. innocuum. Aerobic cultures were positive for Actinomyces. The laboratory was called to determine the species of Actinomyces and reported A. europaeus. The patient\u2019s antibiotics were tailored to meropenem 2\u2005g intravenously every 8\u2005hours and linezolid 600\u2005mg intravenously every 12\u2005hours. The organisms were sent to a reference laboratory for sensitivity testing. Interpretation of sensitivity data and treatment recommendations including duration of therapy are discussed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It is important to rapidly identify the species for both Actinomyces and Clostridium infections and obtain sensitivity values to help ensure proper therapy is given. Interpretation of minimum inhibitory concentrations is difficult without established breakpoints. Piperacillin\/tazobactam resistance has been reported for A. europaeus, while vancomycin resistance has been reported for C. innocuum. For Actinomyces infections, duration of therapy should be individualized and can range from 14 days to 1 year based on patient response and the species.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajhp\/zxaf190","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T11:55:51Z","timestamp":1753271751000},"page":"e946-e955","source":"Crossref","is-referenced-by-count":3,"title":["Treatment of\n                    <i>Actinomyces europaeus<\/i>\n                    and\n                    <i>Clostridium innocuum<\/i>\n                    necrotizing fasciitis: Case report and literature review"],"prefix":"10.1093","volume":"82","author":[{"given":"Lisa","family":"Avery","sequence":"first","affiliation":[{"name":"Pharmacy Department, St. Joseph\u2019s Health , Syracuse, NY"},{"name":"Department of Pharmacy Practice, St. John Fisher University, Wegmans School of Pharmacy , Rochester, NY 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