Empyema - community-acquired
Tailor antibiotics to C&S results.
Usual Pathogens
S. anginosus group
S. pneumoniae
Anaerobes
S. aureus/MRSA
Enterobacterales
H. influenzae
Rare:
Mycobacterium tuberculosis
Nocardia spp
| Empiric Therapy | Duration | |
|---|---|---|
| Ceftriaxone | 1-2g IV daily | 3-6 weeks |
| + | ||
| Metronidazole | 500mg IV/PO q12h |
Ceftriaxone allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Piperacillin-tazobactam | 3.375g IV q6h | 3-6 weeks |
If MRSA suspected/documented, add:
| Empiric Therapy | Duration | |
|---|---|---|
| Vancomycin | 15mg/kg IV q8-12h | 3-6 weeks |
| or | ||
| Linezolid | 600mg IV/PO q12h | 3-6 weeks |