Strategies for the management of bacterial brain abscess

We reviewed the medical and surgical management of brain abscess and compared the results of different methods of treatment. Treatment of brain abscess requires a combination of antimicrobial agents, surgical intervention, and eradication of the primary foci of infection. We believe that pathologic confirmation and/or microbiologic studies are needed to ensure proper management, with the selection of antibiotics based on the available culture and susceptibility results. A 6- to 8-week course of parenteral antibiotics, plus regular follow-up computed tomography scans for at least 3 months to evaluate the therapeutic response is also recommended. The method of surgical treatment is of lesser importance than adherence to the basic principles of abscess management, and which surgical treatment is chosen depends on the patient’s clinical status, the neuroradiographic characteristics of the abscess, and the experience of the surgeons who will be carrying out the procedure.