Guidelines
Cerebral abscess/subdural empyema

Cerebral abscess/subdural empyema

Microbiology

Consult

Neurology, Neurosurgery, ID and/or relevant subspecialty team(s) if required

Culture

Before starting antimicrobial therapy, take blood/urine/CSF and/or other relevant samples for culture wherever possible.

Notes

Consider the need for dose adjustments (e.g. renal impairment) and age-related contraindications for antimicrobials.

First Choice

Cefotaxime may be interchanged with ceftriaxone for children over 30 days old and not on calcium-containing parenteral products (e.g. TPN).

+/-

OR

As anti-MRSA agent (current local MRSA rates are available via the hospital antibiogram)

PLUS

Penicillin Allergy

Cefotaxime may be interchanged with ceftriaxone for children over 30 days old and not on calcium-containing parenteral products (e.g. TPN).

+/-

As anti-MRSA agent (current local MRSA rates are available via the hospital antibiogram)

PLUS

Review Daily

Adjust treatment according to microbiologic results as soon as they become available.

Additional Information

The following factors have been associated with MRSA in previous studies:

  • Previous known MRSA infection in child or a significant contact (e.g. family member)
  • Family member is a healthcare worker
  • First nations child or Pacific Island origin (e.g. Samoan)
  • Day care attendance
  • Prolonged hospitalization in the last 1 year
  • Antibiotic therapy in the last 2 months
  • Critically ill
  • Chronic skin condition (e.g. atopic eczema)