Sandbox brain abscess: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 179: Line 179:
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Sulfadiazine]]: 2-4 g po q6-12h'''''<BR>''PLUS''<BR>▸'''''[[Pyrimethamine]] 25-50 mg po qd'''''<BR>''PLUS''<BR>▸ '''''[[Folinic acid]] 10–25 mg po qd'''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Sulfadiazine]]: 2-4 g po q6-12h'''''<BR>''PLUS''<BR>▸'''''[[Pyrimethamine]] 25-50 mg po qd'''''<BR>''PLUS''<BR>▸ '''''[[Folinic acid]] 10–25 mg po qd'''''
|-
|-
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | OR
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | OR
|-
|-
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[TMP-SMX]] 5/25 mg/kg po or IV q12h for 30 days '''''
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[TMP-SMX]] 5/25 mg/kg po or IV q12h for 30 days '''''

Revision as of 18:16, 27 January 2014

brain abscess

Brain Abscess

  ▸  Primary source

  ▸  Contiguous source

  ▸  Post-traumatic

  ▸  Post-surgical

  ▸  metastatic or cryptogenic

  ▸  Immunocompromised

Primary Source
Preferred Regimen
[[[Cefotaxime]] 2 gm IV q4h
OR
Ceftriaxone 2 gm IV q12h
PLUS
Metronidazole 7.5 mg/kg q6h OR 5 mg/kg IV q12h
Alternative Regimen
Penicllin G 3-4 million units IV q4h
PLUS
Metronidazole 7.5 mg/kg q6h OR 15 mg/kg IV q12h
Contiguous source
Preferred Regimen
Metronidazole 500 mg/kg q8h
PLUS
[[[Cefotaxime]] 2 g IV q6h
OR
Piperacillin/Tazobactam 4.5 g IV q6h
Post-traumatic
Preferred Regimen
[[[Cefotaxime]] 2 g IV q6h
PLUS
Metronidazole 500 mg/kg q8h
PLUS OR NOT
Rifampin 10 mg/kg q24h
Post-surgical
Preferred Regimen
Linezolid 600 mg IV q12h
OR
Vancomycin 15 mg/kg loading dose or 10-15 mg/kg q6h followed by 40-60 mg/kg/24 hourly continuously infusion
PLUS
Rifampin 10 mg/kg qd
PLUS
Meropenem 1.5 g q6h or 2 g q8h
OR
Piperacillin/Tazobactam 4.5 g q6h
metastatic or cryptogenic
Preferred Regimen
Cefataxime 2 g IV q6h
PLUS OR NOT
Metronidazole 500 mg q8h
OR
Ampicillin/Sulbactam 100/50 mg/kg q6h
Immunocompromised
Preferred Regimen(for minimum of 6 wks after resolution of signs)
Pyrimethamine 200 mg po qd then 75 mg/day po
PLUS
Sulfadiazine: 1 gm po q6h if <60 kg, 1.5 gm po q6h if •60 kg
PLUS
Folinic acid 10–25 mg po qd
Alternative Regimen(for 4–6 wks after resolution of signs)
Pyrimethamine 200 mg po qd then 75 mg/day po
PLUS
Folinic acid 10–25 mg po qd
PLUS
Clindamycin 600 mg po IV q6h
OR
TMP/SMX 5/25 mg/kg po qd or IV bid
OR
Atovaquone 750 mg po q6h
Suppression therapy
Sulfadiazine: 2-4 g po q6-12h
PLUS
Pyrimethamine 25-50 mg po qd
PLUS
Folinic acid 10–25 mg po qd
OR
TMP-SMX 5/25 mg/kg po or IV q12h for 30 days