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* Spinal epidural abscess<ref>{{cite book | last = Kasper | first = Dennis | title = Harrison's principles of internal medicine | publisher = McGraw Hill Education | location = New York | year = 2015 | isbn = 978-0071802154 }}</ref> | * Spinal epidural abscess<ref>{{cite book | last = Kasper | first = Dennis | title = Harrison's principles of internal medicine | publisher = McGraw Hill Education | location = New York | year = 2015 | isbn = 978-0071802154 }}</ref> | ||
:* Empiric antimicrobial therapy | :* Empiric antimicrobial therapy | ||
::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h for | ::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h for 2–4 weeks, then PO to complete 6–8 weeks {{and}} [[Ceftriaxone]] 2 g Iv q24h for 2–4 weeks, then PO to complete 6–8 weeks | ||
::: Note (1): Decompressive laminectomy in conjunction with long-term antibiotic therapy tailored to culture results is required. | ::: Note (1): Decompressive laminectomy in conjunction with long-term antibiotic therapy tailored to culture results is required. | ||
::: Note (2): For critically ill patients, a vancomycin loading dose of 20–25 mg/kg may be considered. | ::: Note (2): For critically ill patients, a vancomycin loading dose of 20–25 mg/kg may be considered. | ||
:* Culture-directed antimicrobial therapy | :* Culture-directed antimicrobial therapy | ||
::* Penicillin-susceptible strain | ::* Penicillin-susceptible strain | ||
:::* Preferred regimen: [[Penicillin G]] 4 MU IV q4h for | :::* Preferred regimen: [[Penicillin G]] 4 MU IV q4h for 2–4 weeks, then PO to complete 6–8 weeks | ||
::* Oxacillin-susceptible strain | ::* Oxacillin-susceptible strain | ||
:::* Preferred regimen: [[Oxacillin]] 2 g IV q4h for | :::* Preferred regimen: [[Oxacillin]] 2 g IV q4h for 2–4 weeks, then PO to complete 6–8 weeks | ||
===Brain abscess=== | ===Brain abscess=== | ||
Revision as of 20:02, 1 June 2015
Epidural abscess
- Spinal epidural abscess[1]
- Empiric antimicrobial therapy
- Preferred regimen: Vancomycin 15 mg/kg IV q12h for 2–4 weeks, then PO to complete 6–8 weeks AND Ceftriaxone 2 g Iv q24h for 2–4 weeks, then PO to complete 6–8 weeks
- Note (1): Decompressive laminectomy in conjunction with long-term antibiotic therapy tailored to culture results is required.
- Note (2): For critically ill patients, a vancomycin loading dose of 20–25 mg/kg may be considered.
- Culture-directed antimicrobial therapy
- Penicillin-susceptible strain
- Preferred regimen: Penicillin G 4 MU IV q4h for 2–4 weeks, then PO to complete 6–8 weeks
- Oxacillin-susceptible strain
- Preferred regimen: Oxacillin 2 g IV q4h for 2–4 weeks, then PO to complete 6–8 weeks
Brain abscess
- Brain abscess, bacterial[2]
- Empiric antimicrobial therapy
- Preferred regimen: Vancomycin 15–20 mg/kg IV q8–12h AND (Cefotaxime 2 g IV q4h OR Ceftriaxone 2 g IV q12h) AND Metronidazole 7.5 mg/kg q6h or 15 mg/kg q12h
- Alternative regimen: Penicillin 15–20 mg/kg IV q8–12h AND (Cefotaxime 2 g IV q4h OR Ceftriaxone 2 g IV q12h) AND Metronidazole 7.5 mg/kg q6h or 15 mg/kg q12h
- Brain abscess, tuberculous
- Brain abscess, fungal
References
- ↑ Kasper, Dennis (2015). Harrison's principles of internal medicine. New York: McGraw Hill Education. ISBN 978-0071802154.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.