Hospitalized Adults: Central Nervous System Infections: Brain Abscess

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Doses provided in this table are for patients with normal renal and hepatic function. Click on drug link to go to dosing guidelines.  Some antimicrobials are restricted (ID-R).  Click on link for guidelines on obtaining authorization.

Diagnosis

Common Pathogens

Drug(s) of First Choice

Alternative Drug(s)

Comments

Brain abscess

Streptococci (anaerobic or aerobic)

Bacteroides spp

Prevotella spp

Enterobacteriaceae

Ceftriaxone

2 g IV q12h

PLUS

Metronidazole 500 mg PO/IV q8h

WITH OR WITHOUT*:

Vancomycin

For severe PCN allergy:

Aztreonam ID-R: SFGH 

2 g IV q8h

PLUS

Vancomycin

PLUS

Metronidazole 500 mg PO/IV q8h

ID consultation recommended.

 

*Consider expanded Gram-positive coverage if patient at risk for drug-resistant streptococci or MRSA