Lung abscess

- Careful assessment of risk factors recommended:

  • dental/gingival disease
  • immunosuppression
  • immigration/travel history
  • underlying lung disease.

- Consider TB/mycobacterial, fungal, parasitic etiology.

- Consider noninfectious etiology: malignancy, rheumatologic diseases, pulmonary emboli.

 
Polymicrobial including: Occasionally:
  • Nocardia spp
  • Legionella spp
Empiric Therapy

Dose

Duration
[Ceftriaxone 1-2g IV daily 3-6 weeks
+    
Metronidazole] 500mg IV/PO q12h  
or    
Piperacillin-tazobactam 3.375g IV q6h 

3-6 weeks

If MRSA suspected/documented, add:

Empiric Therapy Dose Duration
Vancomycin 15mg/kg IV q8-12h

3-6 weeks

or    
Linezolid 600mg IV/PO q12h

3-6 weeks