TY - JOUR
T1 - Anti-infective treatment of brain abscess
AU - Bodilsen, Jacob
AU - Brouwer, Matthijs C.
AU - Nielsen, Henrik
AU - van de Beek, Diederik
PY - 2018
Y1 - 2018
N2 - Introduction: Brain abscess is an uncommon and potentially life-threatening infection of the CNS that can be caused by a range of different pathogens including bacteria, fungi, and parasites. A multidisciplinary approach is important and anti-infective treatment remains crucial. Here, we review anti-infective treatment of brain abscess. Areas covered: We used the terms ‘(Brain abscess[ti] AND (antibiotic* OR treatment)) NOT case report’), to conduct a search in the PubMed. Additional papers were identified by cross-reference checking and by browsing textbooks of infectious diseases and neurology. Commentary: 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.
AB - Introduction: Brain abscess is an uncommon and potentially life-threatening infection of the CNS that can be caused by a range of different pathogens including bacteria, fungi, and parasites. A multidisciplinary approach is important and anti-infective treatment remains crucial. Here, we review anti-infective treatment of brain abscess. Areas covered: We used the terms ‘(Brain abscess[ti] AND (antibiotic* OR treatment)) NOT case report’), to conduct a search in the PubMed. Additional papers were identified by cross-reference checking and by browsing textbooks of infectious diseases and neurology. Commentary: 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.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85051564445&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29909695
U2 - https://doi.org/10.1080/14787210.2018.1489722
DO - https://doi.org/10.1080/14787210.2018.1489722
M3 - Review article
C2 - 29909695
SN - 1478-7210
VL - 16
SP - 565
EP - 578
JO - Expert Review of Anti-Infective Therapy
JF - Expert Review of Anti-Infective Therapy
IS - 7
ER -