MedBalans

Lung abscess

Adults · verify locally

Inpatient

First line

  • Ampicillin/sulbactam · i.v./p.o.

    3 g IV q6h → step-down amoxicillin/clavulanate

Alternatives

  • Ceftriaxone + metronidazole · i.v./p.o.

    Ceftriaxone 1–2 g daily + metro 500 mg IV/PO tid

  • Clindamycin (± fluoroquinolone per local protocol) · i.v./p.o.

    Clindamycin 600–900 mg IV tid or 300–450 mg PO tid

Duration

Often 3–6 weeks until clinical + radiographic improvement

Notes

  • Usually aspiration flora; prolonged course until cavity improves.
  • Consider drainage if large / failing medical therapy.

Sputum/BAL or abscess aspirate when drained; blood cultures if septic.