Sandbox brain abscess
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
|
Brain abscess Microchapters |
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Sandbox brain abscess On the Web |
|
American Roentgen Ray Society Images of 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 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
- 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