Liver Abscess

Subset Usual Preferred Alternate IV PO Therapy or

Pathogens IV Therapy IV-to-PO Switch
Therapy
Liver Aerobic Piperacillin/ Quinolone† (IV)* Amoxicillin/clavulanic
abscess GNBs tazobactam plus either acid 875/125 mg (PO)
Enterococci 3.375 gm Metronidazole 1 gm q12h*
(VSE) B (IV) q6h* (IV) q24h* or
fragilis or or Moxifloxacin 400 mg
Tigecycline Clindamycin 600 mg (PO) q24h*
100 mg (IV) (IV) q8h* or combination
× 1 dose, Moxifloxacin 400 therapy
then 50 mg mg with
(IV) q12h* (IV) q24h* Quinolone† (PO)*
or or plus either
Meropenem Sulbactam/ampicillin Metronidazole 500 mg
1 gm 3 gm (IV) q6h (PO) q12h*
(IV) q8h* or or
Clindamycin 300 mg
(PO) q8h*
E histolytica See p 274
Duration of therapy represents total time IV, PO, or IV + PO
* Treat until abscess(es) are no longer present or stop decreasing in size on serial CT scans
† Ciprofloxacin 400 mg (IV) or 500 mg (PO) q12h or Levofloxacin 500 mg (IV or PO) q24h

Abses Liver

Jenis Patogen Rekomendasi Terapi Alternatif Terapi alternatif

Penyakit Terapi (I.V) (I.V) (P.O)
Abses Aerobic GNBs Piperacillin/ Quinolone (.IV) Amoxicillin (asam
Liver Enterococci tazobaktam plus either klavulanat)
(VSE) B fragilis 3.375 gr Metronidazole 1 gr 875/125 mg (P.O) /
(I.V)/6 jam (I.V)/24 jam 12 jam
atau atau atau
Tigecycline 100 Clindamycin 600 mg Moxifloxacin 400
mg (I.V) dosis (I.V)/8 jam mg (P.O)/24 jam
tunggal, Moxifloxacin 400 atau terapi
dilanjutkan 50 mg kombinasi
mg (I.V)/24 jam Quinolone (P.O)
(I.V)/12 jam atau tambah
Meropenem 1 Ampicillin Metronidazole 500
gm sulbaktam 3 gr mg
(I.V)/8 jam (I.V)/6 jam (P,O)/12 jam
atau
Clindamycin 300
mg (P.O)/8 jam