Clinical Features of 141 Cases of Pyogenic Liver Abscess Over a 10-year Period and Antibiotic Sensitivity to the Causative Organisms

Seong Heon Wie; U Im Chang; Jin Dong Kim; Jeong Rok Lee; Chang Nyol Paik; Woo Chul Chung; Kang Moon Lee; Jin Mo Yang

doi:10.3947/ic.2008.40.4.199

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Wie, Chang, Kim, Lee, Paik, Chung, Lee, and Yang: Clinical Features of 141 Cases of Pyogenic Liver Abscess Over a 10-year Period and Antibiotic Sensitivity to the Causative Organisms

ORIGINAL ARTICLES

Infection and Chemotherapy

Infection and Chemotherapy 2008; 40(4): 199-206.

Published online: 25 August 2008

DOI: https://doi.org/10.3947/ic.2008.40.4.199

Clinical Features of 141 Cases of Pyogenic Liver Abscess Over a 10-year Period and Antibiotic Sensitivity to the Causative Organisms

Seong Heon Wie, M.D., U Im Chang, M.D., Jin Dong Kim, M.D., Jeong Rok Lee, M.D., Chang Nyol Paik, M.D., Woo Chul Chung, M.D., Kang Moon Lee, M.D., Jin Mo Yang, M.D.

Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea.

Correspondence: Jin Mo Yang, M.D. Department of Internal Medicine, St. Vincent's Hospital, School of Medicine, The Catholic University of Korea 93-6, Ji-dong, Paldal-gu, Suwon, Gyeonggi-do, 442-723, Korea. Tel:+82-31-249-8211, Fax:+82-31-253-8898, jmyangdr@catholic.ac.kr

Received 29 May 2008 Accepted 7 August 2008

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Pyogenic liver abscess is an acute infectious disease caused by bacteria and can become severe and potentially life-threatening, with a mortality rate of 6-18%. The purpose of this study is to provide the basic informations for the management of liver abscess and the choice of the most effective and economic antibiotics.

Materials and Methods

We investigated clinical, laboratory, radiologic findings and the results of bacteriological studies retrospectively by reviewing the medical records of 141 cases of pyogenic liver abscess patients, admitted to Catholic University St Vincent's Hospital from January 1998 to December 2007.

Results

Patients demographics revealed a mean age of 57.1, (age: 18 to 87), and 71 of the 141 patients were male (50.4%). Cure was achieved in 51 (98.1%) of the 52 patients who were treated with the combination of percutaneous drainage and antibiotics, and in 80 (90.0%) of 89 patients who were treated only with antibiotics. However, there were no significant differences in mortality (P=0.092) and the time to defervescence between both groups. The mean duration of percutaneous drainage was 15.8±9.7 days. Sixty-four of 141 patients showed positive culture results, and K. pneumoniae (70.3%) was the most common organism. Among 45 K. pneumoniae, the rates of resistance were 73.3% to ampicillin, 66.7% to piperacillin, 8.9% to cefazolin, 2.2% to cefuroxime, 0% to ceftriaxone, and 0% to ciprofloxacin.

Conclusions

Combination treatment of intravenous antibiotics and percutaneous drainage was effective for the treatment of pyogenic liver abscess. Initial broad spectrum antibiotic coverage and then switch to first or second cephalosporin according to the susceptibility results, could be recommended especially in patients with monomicrobial K. pneumoniae liver abscess.

Keywords: Liver Abscess, Antibiotics, Drainage

Figures and Tables

Table 1

Demographic and Clinical Features of 141 Patients with Pyogenic Liver Abscess according to the Initial Therapeutic Approaches

Table 2

Overall Antibiotic Susceptibility of 64 Organisms Isolated From Patients with Pyogenic Liver Abscess

^*Abbreviations: AMP, Ampicillin; AMP/SBT, Ampicillin/sulbactam; GM, Gentamicin; AMK, Amikacin; CRXM, Cefuroxime; CZOL, Cefazolin; CTX, Cefotaxime; SXT, Trimethoprim-sulfamethoxazole; CPFX, Ciprofloxacin; PIPC, Piperacillin; TZV, Piperacillin/tazobactam; IMPM, Imipenem

Table 3

Comparison of Demographic and Clinical Features of Pyogenic Liver Abscess between Diabetic and Non-Diabetic Patients

Table 4

Demographic Data, Clinical Outcome, and Complications for Patients with Pyogenic Liver Abscess due to K. pneumoniae Treated with Cefazolin or an Extended-spectrum Cephalosporin after Receiving the Results of the Sensitivity Test

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