Short course antimicrobial therapy in intracranial abscess.

Abstract

In this study, the author attempts to question the necessity of prolonged antimicrobial treatment for intracranial abscess. The C reactive protein (CRP) was measured serially in 26 patients with intracranial abscess. All patients had undergone surgery and were treated with antimicrobial therapy. The CRP was elevated in 20 (77%) patients and its return to normal after treatment correlated with a good recovery. In 3 (12%) patients a persistently high CRP level postoperatively coincided with reformation of the abscess. A transient rise in the CRP value during decrease to normal was due to deep venous thrombosis in 2 (8%) patients. The return of the CRP to normal in conjunction with improvement of the patient's clinical condition and evidence of resolution of the abscess on CT scan were used as a guideline to stop antibiotics early. The antimicrobial therapy of the patients in this series ranged from 11-30 (mean 20) days and the follow up from 6-36 (median 21) months; there have been no recurrences.