Management of brain abscesses with sequential intravenous/oral antibiotic therapy

Eight patients with brain abscesses who refused prolonged hospitalisation w ere treated with a short course (6-12 days) of intravenous antibiotics foll owed by prolonged treatment (15-19 weeks) with an oral antibiotic regimen c onsisting of metronidazole, ciprofloxacin and amoxicillin. All patients res ponded favourably as shown clinically and in imaging studies. No severe adv erse events or sequelae were noted. On admission all patients had a normal or mildly impaired mental status, abscesses less than 3 cm in diameter and no serious predisposing factors. Although combined surgical/medical treatme nt remains the standard approach in management of these patients, the findi ngs suggest chat oral antibiotic therapy only subsequent to a short course of intravenous antibiotics may be an acceptable alternative in selected cas es.