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 includes conservative management with antibiotics alone and percutaneous drainage.[1]

Treatment

  • Antibiotic therapy is the initial treatment of choice followed by percutaneous drainage. If the abscess does not improve on medical therapy or failure to perform percutaneous drainage, open surgical drainage is performed.
  • 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

Alternative Emperic Regimens

  • 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. 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.
  2. 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.
  3. 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.