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Guidelines
Pathogens
Antimicrobials
Escherichia coli, Klebsiella spp., Streptococcus (anginosus group), Enterococcus spp., other viridans streptococci, Bacteroides spp.
Consult interventional radiology or general surgery for drainage. Request gram stain and for anaerobic cultures, as well as histopathology
Obtain blood cultures
If patient is from or has travelled to a region with high endemicity, check amebic serology. Infectious Disease Consultation recommended
Duration depends on adequacy and timing of drainage
Ceftriaxone 1 gm IV 24h
AND
Metronidazole 500 mg IV q8-12h
OR
Piperacillin-tazobactam 3.375 gm IV q6h
Day 3 Bundle