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Treatment and prognosis of bacterial brain abscess

Frederick S Southwick, MD
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Anna R Thorner, MD


Brain abscess is a focal collection within the brain parenchyma, which can arise as a complication of a variety of infections, trauma, or surgery. Successful treatment of a brain abscess requires a high index of suspicion for the infection, which can have subtle presentations and frequently requires a combination of drainage and antimicrobial therapy. A summary of key steps in management is provided in the Table (table 1).

The treatment and prognosis of bacterial brain abscess will be presented here. The pathogenesis, clinical manifestations, and diagnosis of this disease are discussed separately. (See "Pathogenesis, clinical manifestations, and diagnosis of brain abscess".)


Successful management of a brain abscess usually requires a combination of antibiotics and surgical drainage for both diagnostic and therapeutic purposes [1-5].

Antibiotics — A number of drugs can be chosen depending upon the likely origin of the abscess and the probable pathogen(s) involved. These antibiotics include:

Penicillin G covers most mouth flora including both aerobic and anaerobic streptococci. However, the emergence of penicillinase-producing anaerobes (eg, Bacteroides fragilis, Prevotella spp, and others) is a potential limitation of penicillin therapy.

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Literature review current through: Nov 2017. | This topic last updated: Nov 21, 2017.
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