Antimicrobial agent | Dose (adult) | Comment |
Amikacin | 5 mg/kg every 8 hours* | Aminoglycosides are not routinely used for treatment of brain abscess, but may be considered in select cases (eg, multidrug-resistant gram-negative infection when treatment options are limited). |
Ampicillin | 2 g every 4 hours | |
Aztreonam | 2 g every 6 to 8 hours | Alternative agent generally used for patients with severe beta-lactam allergies. |
Cefepime | 2 g every 8 hours | |
Cefotaxime | 2 g every 4 to 6 hours | |
Ceftaroline | 600 mg every 8 hours | Alternative therapy in cases of MRSA that are not responding to vancomycin or linezolid; if used, many experts would combine with another agent effective against MRSA. |
Ceftazidime | 2 g every 8 hours | |
Ceftriaxone | 2 g every 12 hours | |
Ciprofloxacin | 400 mg every 8 to 12 hours | Alternative agent generally used for patients with severe beta-lactam allergies. |
Daptomycin | 6 to 10 mg/kg every 24 hours | Alternative agent for suspected S. aureus (or proven MRSA) in patients who cannot tolerate vancomycin. Daptomycin has poor central nervous system penetration and is generally not recommended; if used because other alternatives are not available, it should be combined with rifampin therapy. |
Gentamicin | 1.7 mg/kg every 8 hours* | Aminoglycosides are not routinely used for treatment of brain abscess, but may be considered in select cases (eg, multidrug-resistant gram-negative infection when treatment options are limited). |
Linezolid¶ | 600 mg every 12 hours | Alternative agent for suspected S. aureus (or proven MRSA) in patients who cannot tolerate vancomycin. |
Meropenem | 2 g every 8 hours | |
Metronidazole | 7.5 mg/kg (usually 500 mg) every 6 to 8 hours; maximum dose: 4 g/day | |
Moxifloxacin | 400 mg every 24 hours | Alternative agent generally used for patients with severe beta-lactam allergies. |
Nafcillin | 2 g every 4 hours | |
Oxacillin | 2 g every 4 hours | |
Penicillin G potassium | 4 million units every 4 hours | |
Rifampin | 600 mg every 24 hoursΔ | Rifampin should not be used as monotherapy, but it may be used in combination with other agents to enhance the antimicrobial activity. |
Tobramycin | 1.7 mg/kg every 8 hours* | Aminoglycosides are not routinely used for treatment of brain abscess but may be considered in select cases (eg, multidrug-resistant gram-negative infection when treatment options are limited). |
Trimethoprim-sulfamethoxazole (co-trimoxazole) | 5 mg/kg every 8 to 12 hours◊ | |
Vancomycin | 15 to 20 mg/kg every 8 to 12 hours§ |
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