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Antimicrobial Agents and Chemotherapy, July 2003, p. 2088-2092, Vol. 47, No. 7
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.7.2088-2092.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Extended-Spectrum Cephalosporin Compared to Cefazolin for Treatment of Klebsiella pneumoniae-Caused Liver Abscess

Hsiao-Pei Cheng,¹ L. K. Siu,² and Feng-Yee Chang^1*

Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center,¹ Division of Clinical Research, National Health Research Institute, Taipei, Taiwan²

Received 18 July 2002/ Returned for modification 9 February 2003/ Accepted 17 April 2003

From January 1995 to May 2000, a total of 107 adults with liver abscess due to Klebsiella pneumoniae admitted at a large medical center in northern Taiwan were reviewed. Patients were considered to have received cefazolin or an extended-spectrum cephalosporin if they received at least 3 days of that antibiotic within the first 5 days of hospitalization. Fifty-nine (55.1%) patients received cefazolin, and 48 (44.9%) patients received an extended-spectrum cephalosporin. The demographic data, clinical features, severities of illness, and rates of early drainage for the two groups were comparable. However, the rates of developing complications for the two groups were significantly different (37.3 versus 6.3%, respectively; P < 0.001). Furthermore, six independent factors preventing severe complications following liver abscess due to K. pneumoniae were identified: normal platelet count, alkaline phosphatase less than 300 U/liter, no gas formation in the abscess, APACHE III score less than 40, use of an extended-spectrum cephalosporin, and early drainage. In conclusion, cefazolin therapy may be suboptimal for patients with liver abscess due to K. pneumoniae despite active in vitro susceptibility. Use of an extended-spectrum cephalosporin and early drainage for patients with liver abscess due to K. pneumoniae are suggested.

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* Corresponding author. Mailing address: Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, No. 325, Sec. 2, Cheng-Kung Rd., Neihu 114, Taipei, Taiwan. Phone: 886-2-8792-7257. Fax: 886-2-8792-7258. E-mail: fychang{at}ndmctsgh.edu.tw.

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Antimicrobial Agents and Chemotherapy, July 2003, p. 2088-2092, Vol. 47, No. 7
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.7.2088-2092.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

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