Pyogenic liver abscess medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
Empiric antibiotic therapy based on culture and sensitivity include | Empiric antibiotic therapy based on culture and sensitivity include | ||
'''First choice''' | '''First choice''' | ||
*1.Monotherapy | *1.Monotherapy | ||
:*Preferred regimen(1):Ampicillin-sulbactam 3 g IV every six hours | :*Preferred regimen(1):[[Ampicillin]]-[[sulbactam]] 3 g IV every six hours | ||
:*Preferred regimen(2):Piperacillin-tazobactam 3.375 or 4.5 g IV every six hours | :*Preferred regimen(2):[[Piperacillin]]-[[tazobactam]] 3.375 or 4.5 g IV every six hours | ||
:*Preferred regimen(3):Ticarcillin-clavulanate 3.1 g IV every four hours | :*Preferred regimen(3):[[Ticarcillin]]-[[clavulanate]] 3.1 g IV every four hours | ||
*2.Combination therapy | *2.Combination therapy | ||
:*Preferred regimen(1):Ceftriaxone 1 g IV every 24 hours or 2 g IV every 12 hours for CNS | :*Preferred regimen(1):[[Ceftriaxone]] 1 g IV every 24 hours or 2 g IV every 12 hours for CNS infection '''plus''' [[Metronidazole]] 500 mg IV every eight hours | ||
'''Alternative Emperic Regimens''' | '''Alternative Emperic Regimens''' | ||
*1.Combination therapy fluoroquinolone PLUS metronidazole | *1.Combination therapy [[fluoroquinolone]] PLUS [[metronidazole]] | ||
:*Preferred regimen(1):Ciprofloxacin 400 mg IV every 12 hours | :*Preferred regimen(1):[[Ciprofloxacin]] 400 mg IV every 12 hours '''or''' [[Levofloxacin]] 500 or 750 mg IV once daily '''Plus''' [[Metronidazole]] 500 mg IV every eight hours | ||
*2.Monotherapy | *2.Monotherapy | ||
:*Preferred regimen(1):Imipenem-cilastatin 500 mg IV every six hours | :*Preferred regimen(1):[[Imipenem]]-[[cilastatin]] 500 mg IV every six hours | ||
:*Preferred regimen(2):Meropenem 1 g IV every eight hours | :*Preferred regimen(2):[[Meropenem]] 1 g IV every eight hours | ||
:*Preferred regimen(3):Doripenem 500 mg IV every eight hours | :*Preferred regimen(3):[[Doripenem]] 500 mg IV every eight hours | ||
:*Preferred regimen(4):Ertapenem 1 g IV once daily | :*Preferred regimen(4):[[Ertapenem]] 1 g IV once daily | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 18:59, 27 February 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Treatment
Treatment of pyogenic liver abscess include:[1]
| Treatment | |||||||||||||||||||||
| Non-surgical treatment | Open surgical drainage | ||||||||||||||||||||
| Conservative management with antibiotics alone | Percutaneous drainage | ||||||||||||||||||||
Medical Therapy
Empiric antibiotic therapy based on culture and sensitivity include
First choice
- 1.Monotherapy
- Preferred regimen(1):Ampicillin-sulbactam 3 g IV every six hours
- Preferred regimen(2):Piperacillin-tazobactam 3.375 or 4.5 g IV every six hours
- Preferred regimen(3):Ticarcillin-clavulanate 3.1 g IV every four hours
- 2.Combination therapy
- Preferred regimen(1):Ceftriaxone 1 g IV every 24 hours or 2 g IV every 12 hours for CNS infection plus Metronidazole 500 mg IV every eight hours
Alternative Emperic Regimens
- 1.Combination therapy fluoroquinolone PLUS metronidazole
- Preferred regimen(1):Ciprofloxacin 400 mg IV every 12 hours or Levofloxacin 500 or 750 mg IV once daily Plus Metronidazole 500 mg IV every eight hours
- 2.Monotherapy
- Preferred regimen(1):Imipenem-cilastatin 500 mg IV every six hours
- Preferred regimen(2):Meropenem 1 g IV every eight hours
- Preferred regimen(3):Doripenem 500 mg IV every eight hours
- Preferred regimen(4):Ertapenem 1 g IV once daily
References
- ↑ Malik AA, Bari SU, Rouf KA, Wani KA (2010). "Pyogenic liver abscess: Changing patterns in approach". World J Gastrointest Surg. 2 (12): 395–401. doi:10.4240/wjgs.v2.i12.395. PMC 3014521. PMID 21206721.