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For further information, see CMDT Part 33-31: Anaerobic Infections
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Common cause of brain abscess, subdural empyema, or septic CNS thrombophlebitis
The organisms reach CNS by direct extension from sinusitis, otitis, or mastoiditis or by hematogenous spread from chronic lung infections
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Antimicrobial therapy is an important adjunct to surgical drainage
Ceftriaxone, 2 g every 12 hours intravenously, plus metronidazole, 500 mg every 8 hours intravenously
Duration of antibiotic therapy is 6–8 weeks but should be based on follow-up imaging
Some small multiple brain abscesses can be treated with antibiotics alone without surgical drainage