Sandbox brain abscess

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

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

Overview

Treatment of brain abscess requires a multidisciplinary approach to delineate extent of infection, plan stereotactic trajectory, aspirate purulent materials, lower intracranial pressure, identify causative pathogen, and administer appropriate antibiotics.

Antimicrobial Therapy – Empiric Therapy

• Cefotaxime 8–12 g/day q4–6h OR Ceftriaxone 4 g/day q12h
  AND
• Metronidazole 30 mg/kg/day q6h

• Meropenem 6 g/day q8h

• Cefotaxime 8–12 g/day q4–6h OR Ceftriaxone 4 g/day q12h
  AND
• Metronidazole 30 mg/kg/day q6h
  AND
• Voriconazole 8 mg/kg/day q12h
  AND
• TMP-SMZ 10–20 mg/kg/day q6–12h OR Sulfadiazine 4–6 g/day q6h

• Cefotaxime 8–12 g/day q4–6h OR Ceftriaxone 4 g/day q12h
  AND
• Sulfadiazine 4–6 g/day q6h
  AND
• Pyrimethamine 25–100 mg/day qd

• Vancomycin 30–45 mg/kg/day q8–12h

• Isoniazid 300 mg qd
  AND
• Rifampin 600 mg qd
  AND
• Pyrazinamide 15–30 mg qd
  AND
• Ethambutol 15 mg/kg/day qd

Antimicrobial Therapy – Pathogen-Based Therapy

• Penicillin G 24 MU q4h

• Metronidazole 30 mg/kg/day q6h

• Cefotaxime 8–12 g/day q4–6h OR Ceftriaxone 4 g/day q12h

• Metronidazole 30 mg/kg/day q6h

• Cefotaxime 8–12 g/day q4–6h OR Ceftriaxone 4 g/day q12h

• Ampicillin 12 g/day q4h OR Penicillin G 24 MU q4h

• TMP-SMZ 10–20 mg/kg/day q6–12h OR Sulfadiazine 4–6 g/day q6h

• Metronidazole 30 mg/kg/day q6h

• Ceftazidime 6 g/day q8h OR Cefepime 6 g/day q8h

• Nafcillin 12 g/day q4h OR Oxacillin 12 g/day q4h

• Vancomycin 30–45 mg/kg/day q8–12h

• Penicillin G 24 MU q4h

• Voriconazole 8 mg/kg/day q12h

• Amphotericin B lipid complex 5 mg/kd/day q24h OR Amphotericin B deoxycholate 15 mg/kg/day q8h

• Amphotericin B lipid complex 5 mg/kd/day q24h OR Amphotericin B deoxycholate 15 mg/kg/day q8h

• Amphotericin B lipid complex 5 mg/kd/day q24h OR Amphotericin B deoxycholate 15 mg/kg/day q8h

• Voriconazole 8 mg/kg/day q12h

• Sulfadiazine 4–6 g/day q6h
  AND
• Pyrimethamine 25–100 mg/day qd