31. RESULTS OF THE ANTIBIOTICS TREATMENT COMBINED WITH LIVER ABSCESS DRAINAGE AT NGUYEN TRI PHUONG HOSPITAL

Huynh Thanh Long1, Nguyen Manh Khiem2, Pham Viet Khuong2
1 Nguyen Tat Thanh University
2 Nguyen Tri Phuong Hospital

Main Article Content

Abstract

Background: Percutaneous drainage of liver abscess is the initial treatment of choice for abscesses more significant than 5 cm in size and has long been applied in many hospitals in Vietnam.


Object: Evaluation of the effectiveness of antibiotic treatment of liver abscess with drainage under ultrasound guidance. Subjects and methods: Retrospective study of patients with a liver abscess who were treated with antibiotics and drained the abscess under ultrasound guidance at Nguyen Tri Phuong Hospital from January 2017 to March 12/2022.


Results: There were 61 patients included in the study. The male/female ratio of 1.65/ first; an average 56.1 ± 12.3 years old, history of diabetes accounted for 32.8%; The prominent clinical symptoms are fever (88.5%), and right upper quadrant pain (85.2%). The liver abscess located in the right liver accounted for 73.4%, most of which was a single abscess (78.7%). First-line antibiotic treatment is Cephalosporin III generation combined with intravenous metronidazole. Most are sensitive to third-generation Cephalosporins (49.2%), 8.2% are multi-resistant ESBL-secreting bacteria using Carbapenems. The treatment success rate is high (96.7%).


Conclusion: Treatment of liver abscess with antibiotics combined with ultrasound-guided drainage is an effective and safe measure. Most cases are only intervention one time with a high success rate.

Article Details

References

[1] Yin D, Ji C, Zhang S et al., Clinical characteristics
and management of 1572 patients with pyogenic
liver abscess: A 12-year retrospective study.
Liver international : official journal of the
International Association for the Study of the
Liver, Apr 2021;41(4):810-818. doi:10.1111/
liv.14760
[2] Serraino C, Elia C, Bracco C et al., Characteristics
and management of pyogenic liver abscess: A
European experience, 2018; 97(19)
[3] He S, Yu J, Wang H et al., Percutaneous fineneedle
aspiration for pyogenic liver abscess
(3-6cm): a two-center retrospective study. BMC
infectious diseases, Jul 16 2020;20(1):516.
doi:10.1186/s12879-020-05239-5
[4] Meddings L, Myers RP, Hubbard J et al.,
A population-based study of pyogenic liver
abscesses in the United States: incidence,
mortality, and temporal trends. The American
journal of gastroenterology. Jan 2010;105(1):117-
24. doi:10.1038/ajg, 2009.614
[5] Van Keer J, Van Keer K, Van Calster J et
al., More Than Meets the Eye: Klebsiella
pneumoniae Invasive Liver Abscess Syndrome
Presenting with Endophthalmitis. The Journal of
emergency medicine. Jun 2017;52(6):e221-e223.
doi:10.1016/j.jemermed, 2017.01.043
[6] Sanchez WM, Abaunza HO, Hepatic Abscess:
Current Concepts, 2009.
[7] Bansal A, Bansal AK, Bansal V et al., Liver
abscess: catheter drainage v/s needle aspiration.
J International Surgery Journal, 2016;2(1):20-25.
[8] Singh S, Chaudhary P, Saxena N et al.,
Treatment of liver abscess: prospective
randomized comparison of catheter drainage and
needle aspiration. Annals of gastroenterology,
2013;26(4):332-339.
[9] Abusedera MA, El-Badry AM, Percutaneous
treatment of large pyogenic liver abscess,
2014;45(1):109-115.