Spectrum: Local Antimicrobial Stewardship, for Island Health

Complicated Effusion or CA Empyema

Duration of Therapy

3-6 weeks

Depending on clinical response and adequacy of chest drainage

Antimicrobial Therapy

Ceftriaxone 2g IV DAILY

AND

Metronidazole 500mg PO/IV BID

IF MRSA isolated ADD

Vancomycin 15mg/kg, based on nomogram

Microbiology

Usual Pathogens

Streptococcus anginosus

Streptococcus pneumoniae

Anaerobes

Staphylococcus aureus

Enterobacteriaceae