Outcome of medical treatment of bacterial abscesses without therapeutic drainage: review of cases reported in the literature.
The usual treatment of bacterial abscesses, except lung or tubo-ovarian abscesses, includes therapeutic drainage. Increasing evidence suggests that some abscesses respond to antimicrobial therapy without drainage. To study this issue, a MEDLINE search of the literature (1966-1994) was performed for cases of bacterial abscess in which treatment without definitive drainage was attempted. Four hundred sixty-five cases were identified. The most commonly involved organs were the liver, brain, and kidney. The success rate of antimicrobial therapy was 85.9%. Factors that predicted a less favorable outcome were abscess diameter of > or = 5 cm (odds ratio [OR] = 37.7; P = .0003), involvement of > or = 1 organism (OR = 5.2; P = .014), presence of gram-negative bacilli (OR = 3.4; P = .022), length of therapy of < 4 weeks (OR = 49.1; P < .0001), and use of an aminoglycoside as the only active agent (OR = 11.8; P = .008). Many bacterial abscesses can be treated without drainage; abscess size, the organisms involved, and therapy utilized may influence outcome.
Bamberger
D M
DM
Section of Infectious Diseases, University of Missouri-Kansas City School of Medicine 64113, USA.
D000038:Abscess / Q000188:drug therapy* / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy; D006801:Humans
D000900:Anti-Bacterial Agents