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Lung Abscess

S. pneumoniae, S. pyogenes, MSSA/MRSA

 

If secondary to aspiration: polymicrobial infection with oral aerobes and anaerobes

Ceftriaxone 75mg/kg/dose IV q24h (max 2000mg/dose)

AND

Clindamycin 40mg/kg/day IV div q8h (max 600mg/dose)¹

 

If requiring ICU level care, REPLACE Clindamycin with Vancomycin [see dosing recommendations in Bugs and Drugs Section]

Empiric Therapy & Alternative Regimens

Duration of Therapy & Clinical Pearls

Consult Infectious Diseases.

 

Consult General Surgery to discuss possible drainage.

 

Send fluid for Gram Stain and culture if drainage performed.

 

IV to PO transition: Consider once afebrile and clinically improved. 

Length of Therapy (IV+PO):

Often requires extended course of antibiotics (4-6 weeks) depending on severity of infection, discuss with Infectious Diseases¹

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