Escherichia coli, Klebsiella spp., Streptococcus anginosus group, Enterococcus spp., other viridans Streptococci, Bacteroides spp.
Consult interventional radiology or general surgery for drainage. Request aerobic and anaerobic cultures, as well as histopathology
Obtain blood cultures
If patient is from or has travelled to a region with high endemicity, send aspirate for parasite examination and test Entamoeba serology. Infectious Disease Consultation recommended.
Depends on adequacy and timing of drainage
Ceftriaxone 2 gm IV 24h
Metronidazole 500 mg PO/IV BID
Metronidazole oral absorption ~ 100%
Amoxicillin-clavulanate 1g IV q8h (monotherapy)
Day 3 Bundle