{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T18:40:20Z","timestamp":1792348820229,"version":"4.4.0"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trop Doct"],"abstract":"<jats:p>\n                    Actinomycetoma is a chronic, destructive infection of the skin and subcutaneous tissues that is often treated empirically in endemic settings because species identification and antimicrobial susceptibility testing are unavailable or delayed. We developed an Evidence-Concordance Framework (ECF) integrating published clinical outcomes, phenotypic susceptibility data and CARD-RGI resistome predictions for major\n                    <jats:italic toggle=\"yes\">Nocardia<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Actinomadura<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">Streptomyces<\/jats:italic>\n                    pathogens. Amikacin and linezolid showed the strongest concordance across the three evidence domains. Trimethoprim\u2013sulfamethoxazole (TMP\u2013SMX) remained the therapeutic backbone despite variable in vitro susceptibility, particularly among\n                    <jats:italic toggle=\"yes\">Streptomyces<\/jats:italic>\n                    . Genomic resistance determinants often showed limited agreement with phenotypic or clinical outcomes. The ECF therefore supports TMP\u2013SMX-based therapy, with amikacin and linezolid as strongly supported adjunctive or alternative agents. Genomic prediction should complement, not replace, clinical judgement, species identification and phenotypic susceptibility testing.\n                  <\/jats:p>","DOI":"10.1177\/00494755261499053","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:16:22Z","timestamp":1792070182000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimising empirical therapy for actinomycetoma in diagnostic-limited settings: Prioritising Amikacin and Linezolid via an Integrated Evidence-Concordance Framework"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0085-827X","authenticated-orcid":false,"given":"Mohamed E.","family":"Hamid","sequence":"first","affiliation":[{"name":"College of Medicine, King Khalid University","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Saadeldein","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Gezira","place":["Sudan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002550"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003679"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010128"},{"key":"e_1_3_2_5_2","article-title":"CARD 2020: antibiotic resistome surveillance with the comprehensive antibiotic resistance database","volume":"48","author":"Alcock BP","year":"2020","unstructured":"Alcock BP, Raphenya AR, Lau TTY, et al. CARD 2020: antibiotic resistome surveillance with the comprehensive antibiotic resistance database. Nucleic Acids Res 2020; 48: D517\u2013D525.","journal-title":"Nucleic Acids Res"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/1476-0711-10-24"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmni.2021.100946"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1991.tb03892.x"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.32888"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.16764"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003218"}],"container-title":["Tropical Doctor"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00494755261499053","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00494755261499053","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00494755261499053","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T17:47:48Z","timestamp":1792345668000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00494755261499053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":10,"alternative-id":["10.1177\/00494755261499053"],"URL":"https:\/\/doi.org\/10.1177\/00494755261499053","relation":{},"ISSN":["0049-4755","1758-1133"],"issn-type":[{"value":"0049-4755","type":"print"},{"value":"1758-1133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]},"article-number":"00494755261499053"}}