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 infections
:*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
                          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
                            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
  • 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

  • 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. 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.