Pleural empyema medical therapy

Empyema Main Page
Pleural empyema Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Pleural empyema from other Diseases
Epidemiology and Demographics
Screening
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
ECG
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Pleural empyema medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Pleural empyema medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Pleural empyema medical therapy
CDC on Pleural empyema medical therapy
Pleural empyema medical therapy in the news
Blogs on Pleural empyema medical therapy
Directions to Hospitals Treating Pleural empyema
Risk calculators and risk factors for Pleural empyema medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

Definitive treatment for empyema entails drainage of the infected pleural fluid. A chest tube may be inserted, often using ultrasound guidance. Intravenous antibiotics are given. If this is insufficient, surgical debridement of the pleural space may be required.

Antibiotic Therapy

Following are the guidelines to treat Pleural empyema .

▸ Click on the following categories to expand treatment regimens.

Pleural Empyema   ▸   Neonates   ▸   Infants/Children   ▸   Adult   ▸   Subdural

Neonates Preferred Regimen Age 0-7 days and Weight ≤ 2000 gm ▸ If MSSA ▸ Nafcillin 25 mg/kg IV q12h OR Oxacillin 25 mg/kg IV q12h ▸ If MRSA ▸ Vancomycin 12.5 mg/kg IV q12h Age 7-28 days and Weight ≤ 2000 gm ▸ If MSSA ▸ Nafcillin 25 mg/kg q8h OR Oxacillin 25 mg/kg IV q12h ▸ If MRSA ▸ Vancomycin 15 mg/kg IV q12h Age 0-7 days and Weight > 2000 gm ▸ If MSSA ▸ Nafcillin 25 mg/kg q8h OR Oxacillin 25 mg/kg IV q12h ▸ If MRSA ▸ Vancomycin 18 mg/kg IV q12h Age 7-28 days and Weight > 2000 gm ▸ If MSSA ▸ Nafcillin37 mg/kg q6h OR 'Oxacillin 37 mg/kg q6h ▸ If MRSA ▸ Vancomycin 22 mg/kg q12h

Infants/Children Preferred Regimen ▸Cefotaxime 100 mg/kg IV q8h OR Ceftriaxone 100 mg/kg IV q24h 'If MSSA ▸ Vancomycin 40 mg/kg/day IV in 3-4 divided doses With or Without 'Cefotaxime 100 mg/kg IV q8h OR Ceftriaxone 100 mg/kg IV q24h If H.Influenzae suspected

Adult Preferred Regimen Strep. pneumoniae or Streptococcus sp (Group A) ▸Cefotaxime 2 gm IV q8h OR ▸Ceftriaxone 2 gm IV q24h or Penicillin 12-18 million units IV divided q4h/day OR ▸Ampicillin 8-12 gm IV divided q4h/day Staph. aureus ▸MSSA Nafcillin2 gm IV q4h OR Oxacillin 2 gm IV q4h ▸MRSA Vancomycin 10-15 mg/kg IV q8-12h OR Linezolid 600 mg IV q12h H. influenzae ▸Ceftriaxone 2 gm IV q24h Subacute/Chronic ▸Clindamycin 450-900 mg IV q8h PLUS 'Ceftriaxone 2 gm IV q24h