Sandbox brain abscess: Difference between revisions
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==Antimicrobial Therapy – Empiric Therapy== | ==Antimicrobial Therapy – Empiric Therapy== | ||
{{rx|Preferred regimen}} | {{rx|Preferred regimen}} | ||
<li>[[Cefotaxime]] 8–12 g/day q4–6h <u>OR</u> [[Ceftriaxone]] 4 g/day q12h< | <li>[[Cefotaxime]] 8–12 g/day q4–6h <u>OR</u> [[Ceftriaxone]] 4 g/day q12h<font color="#777777"> {{and}} </font></li> | ||
<li>[[Metronidazole]] 30 mg/kg/day q6h</li> | <li>[[Metronidazole]] 30 mg/kg/day q6h</li> | ||
</ul> | </ul> | ||
{{rx|Alternative regimen}} | |||
<li>[[Meropenem]] 6 g/day q8h</li> | <li>[[Meropenem]] 6 g/day q8h</li> | ||
</ul> | </ul> | ||
<ul class="mw-collapsible mw-collapsed" data-expandtext="Transplant recipients" data-collapsetext="Transplant recipients"> | <ul class="mw-collapsible mw-collapsed" data-expandtext="Transplant recipients" data-collapsetext="Transplant recipients"> | ||
<li>[[Cefotaxime]] 8–12 g/day q4–6h <u>OR</u> [[Ceftriaxone]] 4 g/day q12h | <li>[[Cefotaxime]] 8–12 g/day q4–6h <u>OR</u> [[Ceftriaxone]] 4 g/day q12h {{and}} </li> | ||
<li>[[Metronidazole]] 30 mg/kg/day q6h | <li>[[Metronidazole]] 30 mg/kg/day q6h {{and}} </li> | ||
<li>[[Voriconazole]] 8 mg/kg/day q12h | <li>[[Voriconazole]] 8 mg/kg/day q12h {{and}} </li> | ||
<li>[[TMP-SMZ]] 10–20 mg/kg/day q6–12h <u>OR</u> [[Sulfadiazine]] 4–6 g/day q6h</li> | <li>[[TMP-SMZ]] 10–20 mg/kg/day q6–12h <u>OR</u> [[Sulfadiazine]] 4–6 g/day q6h</li> | ||
</ul> | </ul> | ||
<ul class="mw-collapsible mw-collapsed" data-expandtext="Patients with HIV/AIDS" data-collapsetext="Patients with HIV/AIDS"> | <ul class="mw-collapsible mw-collapsed" data-expandtext="Patients with HIV/AIDS" data-collapsetext="Patients with HIV/AIDS"> | ||
<li>[[Cefotaxime]] 8–12 g/day q4–6h <u>OR</u> [[Ceftriaxone]] 4 g/day q12h | <li>[[Cefotaxime]] 8–12 g/day q4–6h <u>OR</u> [[Ceftriaxone]] 4 g/day q12h {{and}} </li> | ||
<li>[[Sulfadiazine]] 4–6 g/day q6h | <li>[[Sulfadiazine]] 4–6 g/day q6h {{and}} </li> | ||
<li>[[Pyrimethamine]] 25–100 mg/day qd</li> | <li>[[Pyrimethamine]] 25–100 mg/day qd</li> | ||
</ul> | </ul> | ||
| Line 29: | Line 29: | ||
</ul> | </ul> | ||
<ul class="mw-collapsible mw-collapsed" data-expandtext="Mycobacterium tuberculosis coverage" data-collapsetext="Mycobacterium tuberculosis coverage"> | <ul class="mw-collapsible mw-collapsed" data-expandtext="Mycobacterium tuberculosis coverage" data-collapsetext="Mycobacterium tuberculosis coverage"> | ||
<li>[[Isoniazid]] 300 mg qd | <li>[[Isoniazid]] 300 mg qd {{and}} </li> | ||
<li>[[Rifampin]] 600 mg qd | <li>[[Rifampin]] 600 mg qd {{and}} </li> | ||
<li>[[Pyrazinamide]] 15–30 mg qd | <li>[[Pyrazinamide]] 15–30 mg qd {{and}} </li> | ||
<li>[[Ethambutol]] 15 mg/kg/day qd</li> | <li>[[Ethambutol]] 15 mg/kg/day qd</li> | ||
</ul> | </ul> | ||
Revision as of 02:02, 19 April 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Brain abscess Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Sandbox brain abscess On the Web |
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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