Lung abscess

J85.0/J85.1/J85.2/J85.3

• General Measures
• Medicine Treatment
• Referral

GENERAL MEASURES

Physiotherapy and regular emphasis on postural drainage is essential for management.

Instruct patient to do chest clearance exercises (taught by a physiotherapist where possible) for at least 20 minutes, 6 hourly.

Nutritional support.

MEDICINE TREATMENT

• Amoxicillin/clavulanic acid, IV, 1.2 g 8 hourly, until patient apyrexial for 24 hours.

Follow with:

• Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly.

Severe penicillin allergy: (Z88.0)

• Moxifloxacin, IV, 400 mg daily, until patient apyrexial for 24 hours.

Follow with:

• Moxifloxacin, oral, 400 mg daily.

LoEII [34]

Duration of therapy

Usually 4-6 weeks - monitor with repeat CXR every 1-2 weeks, which should show disappearance of air-fluid level and reduction in size of abscess.

REFERRAL

• No response to treatment.
• CXR not resolving or worsening.
• Complications, such as empyema or severe haemoptysis.