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Table 1 Antibiotic treatment recommendations for the ORAL triala

From: Partial oral antibiotic treatment for bacterial brain abscess: an open-label randomized non-inferiority trial (ORAL)

  Intervention group (2 weeks IV + 4 weeks oral) Standard group (6 weeks IV)
First 2 weeks Ceftriaxone 4 g × 1 / cefotaxime 3 g × 4 + metronidazole 500 mg × 3 Ceftriaxone 4 g × 1 / cefotaxime 3 g × 4 + metronidazole 500 mg × 3
Next 4 weeks Oral amoxicillin 1 g × 4 + metronidazole 500 mg × 3 Ceftriaxone 4 g × 1 / cefotaxime 3 g × 4 + metronidazoleb 500 mg × 3
In case of Streptococcal spp. with a minimal inhibitory concentration for penicillin ≥1 mg/L, beta-lactam allergy, non-susceptibility, interaction with other drugs, or development of drug fever. a) Oral moxifloxacin 400 mg × 1 + metronidazole 500 mg × 3
b) Oral linezolid 600 mg × 2 + metronidazole 500 mg × 3
c) Oral clindamycin 600 mg × 4
a) Meropenem 2 g × 3
b) Moxifloxacin 400 mg × 1 + metronidazole 500 mg × 3
c) Clindamycin 600 mx 4
  1. aOther drug regimens may be chosen by the local study investigator at each site according to international or local guidelines, regional epidemiology of brain abscess bacteria, susceptibility of the causative pathogen(s), renal or liver impairment, or in case of drug interactions, intolerability or toxicity. Such changes should be consulted with infectious disease specialists and/or clinical microbiologist taking into consideration the pharmacokinetic/pharmacodynamic properties of the chosen antibiotics
  2. bCan be replaced by oral metronidazole and may be stopped earlier during treatment to limit risk of side effects at the discretion of the treating physician