====== Brain abscess treatment ======

Once an abscess has formed, surgical excision or drainage combined with prolonged antibiotics (usually 4-8 weeks) remains the treatment of choice.

Early diagnosis with neuroradiological imaging, infection blood markers, and microbiological identification of the causative pathogen is crucial for treatment with surgical drainage (needle drainage for some) or excision and specific [[antibiotic]] therapy, which guarantees a good outcome and long-term survival. In fact, while prompt diagnosis and treatment guarantee good outcomes and long-term survival, morbidity and mortality are very high in case of misdiagnosis
((Rigante L, Tufo T, Scoppettuolo G, Donato C, Mangiola A. Brain abscess
developing in a non-operated spontaneous intracerebral haemorrhage: a case report
and literature review. Turk Neurosurg. 2013;23(6):835-9. doi:
10.5137/1019-5149.JTN.6591-12.2. PubMed PMID: 24310475.
)).

===== Brain abscess management =====

see [[Brain abscess management]].

===== Medical treatment =====

[[Empiric therapy]] of [[bacteria]]l [[brain abscess]] consists of [[cefotaxime]] and [[metronidazole]] with the addition of [[vancomycin]] if [[methicillin]]-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 abscesses. Future studies should address the efficacy and safety of continuous abscess drainage, mode of anti-infective administration (continuous vs. bolus), and anti-infective treatments in immuno-suppressed patients
((Bodilsen J, Brouwer MC, Nielsen H, Van De Beek D. Anti-infective treatment of 
brain abscess. Expert Rev Anti Infect Ther. 2018 Jul;16(7):565-578. doi:
10.1080/14787210.2018.1489722. Epub 2018 Jul 5. PubMed PMID: 29909695.
)).
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[[Antibiotics for brain abscess]]


===== Brain abscess surgery =====

see [[Brain abscess surgery]].