Effects of Prolonged Antibiotic Therapy in Lung Abscesses—Analysis of Case Series

TL;DR

Prolonged antibiotic therapy can effectively treat lung abscesses without surgery, but more research is needed due to limited evidence.

Contribution

The study presents four cases showing clinical improvement with prolonged antibiotic therapy for large lung abscesses.

Findings

Prolonged antibiotic therapy led to clinical improvement and lesion regression in four lung abscess cases.

Surgical drainage was not required in the presented cases.

The study highlights challenges in managing lung abscesses due to antimicrobial resistance and lack of treatment consensus.

Abstract

The incidence and mortality rate of lung abscess cases have declined significantly following the widespread introduction of broad-spectrum antibiotic therapy. Administration of antibiotics is considered the main treatment option, replacing invasive management, which currently is reserved only for selected patients. Four cases of patients with large lung abscesses analyzed in the article demonstrate the effectiveness of prolonged antibiotic therapy in the form of clinical improvement and regression of lesions imaged with computed tomography (CT) scans, in the absence of surgical drainage. However, the lack of a comparator group undergoing surgical interventions limits the ability to generalize the findings. The article highlights multiple diagnostic and management challenges clinicians face when treating complicated lung abscesses; however, the presented evidence is limited by a small sample size and lack of controls. Although the incidence of lung abscesses has dropped, they are still frequently seen in pulmonology, surgery, pediatrics, and internal medicine departments. In the face of the worldwide antimicrobial resistance crisis, the choice of effective antibiotic therapy remains a challenge, and there is no consensus on the duration of the treatment, as well as specific timing for introducing surgical intervention. As there are no high-quality recommendations or international studies evaluating the epidemiology of lung abscesses in the 21st century, further research seems necessary to help clinicians make appropriate therapeutic decisions.

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