Pyogenic liver abscess medical therapy
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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 of pyogenic liver abscess include non-surgical treatment and open surgical drainage. Non-surgical treatment treatment includes conservative management with antibiotics alone and percutaneous drainage.[1]
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:[2][3]
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
- ↑ 1.0 1.1 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.
- ↑ Chen YW, Chen YS, Lee SS, Yen MY, Wann SR, Lin HH; et al. (2002). "A pilot study of oral fleroxacin once daily compared with conventional therapy in patients with pyogenic liver abscess". J Microbiol Immunol Infect. 35 (3): 179–83. PMID 12380791.
- ↑ Yu SC, Ho SS, Lau WY, Yeung DT, Yuen EH, Lee PS; et al. (2004). "Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration". Hepatology. 39 (4): 932–8. doi:10.1002/hep.20133. PMID 15057896.