Empyema - community-acquired

- Pleural fluid should be tapped ASAP and antibiotics re-assessed if Gram stain positive.

 
Usual Pathogens

S. anginosus group
S. pneumoniae
Anaerobes
S. aureus/MRSA
Enterobacterales
H. influenzae

 
Rare:

Mycobacterium tuberculosis
Nocardia spp

 

Empiric Therapy

Dose

Duration
Ampicillin 200mg/kg/d IV div q6h 3 weeks

ICU admission:

Empiric Therapy Dose Duration
Vancomycin 60mg/kg/d IV div q6h 3 weeks
+    
Ceftriaxone 100mg/kg IV q24h