Lung Abscess

General measures

Medicine treatment

Referral

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J85.0-3

GENERAL MEASURES

• Physiotherapy and regular emphasis on postural drainage is essential for management.
• Instruct patient to do chest clearance exercises (taught by a physiotherapist where possible) for at least 20 minutes, 6 hourly.
• Nutritional support.

MEDICINE TREATMENT

• Amoxicillin/clavulanic acid, IV, 1.2 g 8 hourly, until patient apyrexial for 24 hours.

Follow with:

• Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly.

LoE:III

Severe penicillin allergy: (Z88.0)

• Moxifloxacin, IV, 400 mg daily, until patient apyrexial for 24 hours.

Follow with:

• Moxifloxacin, oral, 400 mg daily.

LoE:II^xxxviii

Duration of therapy

• Usually 4-6 weeks - monitor with repeat CXR every 1-2 weeks, which should show disappearance of air-fluid level and reduction in size of abscess.

REFERRAL

• No response to treatment.
• CXR not resolving or worsening. 
• Complications, such as empyema or severe haemoptysis.

Click here to access the pdf.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2020-2024_Version 1.1_16 September 2024

Chapter 16: Respiratory Disorders _16.5 Lung Abscess