Brain abscess

Patient Population: Adult
Diagnosis Common Pathogens Drug(s) of First Choice Alternative Drug(s) Comments Expected Duration

Brain abscess (community-acquired)

Streptococci (anaerobic or aerobic)

Bacteroides spp

Prevotella spp

Enterobacterales

Ceftriaxone 2g IV q12h

PLUS

Metronidazole

PLUS

Vancomycin 

 

For severe PCN allergy:

Aztreonam

PLUS

Vancomycin

PLUS

Metronidazole

 

ID consultation recommended

Brain abscess (post-neurological procedure)

Streptococci (anaerobic or aerobic)

Anaerobes

Enterobacterales

S. aureus & coagulase-negative Staphylococcus spp

Pseudomonas aeruginosa

Acinetobacter spp.

Cefepime

PLUS

Vancomycin

PLUS

Metronidazole

 

For severe PCN allergy:

Aztreonam

PLUS

Vancomycin

PLUS

Metronidazole

  ID consultation recommended