The rational use of antibiotics in the treatment of brain abscess

The Working Party was instituted to investigate the rationale of therapeuti c antibiotic usage in patients with brain abscess and to make recommendatio ns for current practice. A systematic review of English language publicatio ns on brain abscess over the last 25 years was carried out using electronic databases and secondary sources, and data were evaluated. Few publications were identified where the microbiological procedures were adequately descr ibed and many authors continue to report sterile pus in a proportion of cas es. The vast majority of reports were retrospective neurosurgical assessmen ts in which details of laboratory procedures and antibiotic regimens were m issing. There are no published reports of controlled clinical trials or com parative therapeutic studies. The recommendations made by the Working Party are based on relevant published information and the expertise of Working P arty members. Recommendations vary according to the location of the abscess which reflects the likely source of the infection and therefore the bacter ial types most likely to be present in aspirated pus. Bacteria with multipl e resistance to antimicrobial agents do not feature significantly in cases of brain abscess.