Spectrum: Local Antimicrobial Stewardship, for Eastern Health

Liver Abscess

Usual Organisms

Escherichia coli, Klebsiella spp., Streptococcus anginosus group, Enterococcus spp., other viridans Streptococci, Bacteroides spp.

Management

Consult interventional radiology or general surgery for drainage. Request aerobic and anaerobic cultures, as well as histopathology

Obtain blood cultures

If patient is from or has travelled to a region with high endemicity, send aspirate for parasite examination and test Entamoeba serology. Infectious Disease Consultation recommended.

Empiric Therapy Pending Further Workup for Bacterial Liver Abscess

Duration depends on adequacy and timing of drainage

Ceftriaxone 2 gm IV 24h

AND

Metronidazole 500 mg PO/IV BID

Metronidazole oral absorption ~ 100%

Reassess Therapy on Day 3

Day 3 Bundle