Md Atiar Rahman and Md Mizanur Rahman
Background and aims Children with a lung abscess usually do well with antibiotics alone and surgical intervention is rarely needed. Standard practice is to use parenteral antibiotics until clinical symptoms abate and to follow with oral antibiotics for up to six weeks. The objective of this study was to observe and compare outcome, duration of antimicrobial treatment for lung abscess. Methods A prospective open, randomized clinical trial was conducted among 30 children aged 5 to 15 years with lung abscess and sequential antibiotic therapy either clindamycin (group 1; n=15) or ceftriaxone, flucloxacillin plus metronidazole (group 2; n =15) were administered until complete resolution of clinical and radiological abnormalities. Results Mean age was 11.5 years in group 1 and 11 years in group 2. Blood culture was negative in all cases but in sputum 33% cases staphylococcus aureus and 20% cases streptococcus pneumoniae was found and was sensitive to clindamycin, flucloxacillin and ceftriaxone. ESR exceeded 20 mm/hour in 94% and CRP exceeded 20 mg/L in 95% of the cases. ESR became normal in 21 days and CRP in 10 days and the cavity size on chest radiography was reduced after 14 days of treatment in first group but in second group CRP in 15 days, ESR in 28 days and reduced cavity size in 28 days. Mean duration of therapy was 21 days for first group and 39 days in second group. There were significant differences between the duration of treatment and outcome of the two groups (P<0.05. Conclusions Clindamycin appears to be effective short course treatment option in lung abscess.
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