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brain_abscess_treatment

Brain abscess treatment

Empiric treatment of bacterial brain abscess consists of cefotaxime and metronidazole with the addition of vancomycin if meticilline-resistant Staphylococcus aureus is suspected. For severely immuno-suppressed patients, for example transplant recipients, voriconazole and trimethoprim-sulfamethoxazole or sulfadiazine should be added. Increased knowledge of the pharmacokinetic profile of anti-infective treatments may help to improve the treatment of brain abscess. Future studies should address efficacy and safety of continuous abscess drainage, mode of anti-infective administration (continuous vs. bolus), and anti-infective treatments in immuno-suppressed patients 1).

see Brain abscess management.

see Brain abscess surgery.

Once an abscess has formed, surgical excision or drainage combined with prolonged antibiotics (usually 4-8 weeks) remains the treatment of choice.

Early diagnosis with neuroradiological imaging, infection blood markers and microbiological identification of the causative pathogen is crucial for treatment with surgical drainage (needle drainage for some) or excision and specific antibiotic therapy, which guarantee good outcome and long-term survival. In fact, while prompt diagnosis and treatment guarantee good outcome and long-term survival, morbidity and mortality are very high in case of misdiagnosis 2).

1)
Bodilsen J, Brouwer MC, Nielsen H, Van De Beek D. Anti-infective treatment of brain abscess. Expert Rev Anti Infect Ther. 2018 Jul;16(7):565-578. doi: 10.1080/14787210.2018.1489722. Epub 2018 Jul 5. PubMed PMID: 29909695.
2)
Rigante L, Tufo T, Scoppettuolo G, Donato C, Mangiola A. Brain abscess developing in a non-operated spontaneous intracerebral haemorrhage: a case report and literature review. Turk Neurosurg. 2013;23(6):835-9. doi: 10.5137/1019-5149.JTN.6591-12.2. PubMed PMID: 24310475.
brain_abscess_treatment.txt · Last modified: 2018/09/08 14:47 by administrador