Effective medical therapy of a lung abscess should result in fever defervesence and a reduction in symptoms within a reasonable period of time.
Criteria for delayed defervescence:
(1) fever (> 38°C)
(2) persisting > 7 days
(3) after starting effective antibiotic therapy
Causes of delayed defervesence:
(1) another cause for the fever (occult abscess, drug fever, etc)
(2) organisms resistant to the antibiotic therapy (use of presumptive therapy, superinfection with another organism, failure to isolate all pathogens)
(3) failure in administration of the antibiotic (nonadherence, insufficient dose, other)
(4) failure of the antibiotic to achieve adequate levels within the abscess cavity
(5) defect in host defenses
Endoscopic or surgical drainage may be necessary if optimum medical therapy is unable to resolve the infection.
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Specialty: Infectious Diseases, Pharmacology, clinical, Pulmonology
