Subdural empyema
- Typically secondary to otorhinologic infections or head trauma/cranial surgery.
- Diagnosis: MRI
- Condition usually requires urgent surgical drainage.
Usual Pathogens
Polymicrobial:
Viridans Group Streptococci
Streptococcus anginosus group
Anaerobes:
- Anaerobic Gram positive cocci
- Bacteroides fragilis
- Prevotella/Porphyromonas spp
- Fusobacterium spp
Empiric Therapy | Dose | Duration |
---|---|---|
Ceftriaxone | 2g IV q12h | 6 weeks |
+ | ||
Metronidazole IV/PO | 500mg IV/PO q8h |
Post-neurosurgical/osteomyelitis
Also:
S. aureus
Cutibacterium acnes
Empiric Therapy | Dose | Duration |
---|---|---|
Ceftriaxone | 2g IV q12h | 6 weeks |
+ | ||
Vancomycin | 15mg/kg IV q8-12h | |
+ | ||
500mg IV/PO q8h |