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Published on: July 31, 2016
Intermittent hepatic artery antibiotic infusion therapy for pyogenic hepatic abscess
M Matoba1, H Tonami, M Kuginuki
1Department of Radiology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan. m-matoba@kanazawa-med.ac.jp
Purpose:
To study the efficacy and problems associated with intermittent hepatic artery antibiotic infusion therapy for pyogenic hepatic abscess.
Material And Methods:
The material comprised eight patients with pyogenic hepatic abscess in whom percutaneous drainage could not be performed and intravenous administration of antibiotics was ineffective. An injection catheter was introduced into the common hepatic artery. Almost the same dose of antibiotics as with intravenous administration was infused intra-arterially 2-4 times per day.
Results:
A therapeutic effect was achieved in six of the eight cases. In these 6 cases, the mean period of intra-arterial infusion was 10.8 days, while the mean period of catheter placement was 14.7 days. Using broad spectrum antibiotics, the therapeutic effect was obtained regardless of the numbers, morphologic characteristics, and differences in location of the abscesses. No significant complications were noted except in one case of splenic infarction.
Conclusion:
Intermittent hepatic artery antibiotic infusion therapy is useful as an alternative therapeutic procedure for pyogenic hepatic abscess in which percutaneous drainage cannot be performed and intravenous administration of antibiotics is ineffective.
Insights
Intermittent hepatic artery antibiotic infusion therapy effectively treated pyogenic hepatic abscesses when other methods failed. This approach offers a viable alternative for complex cases, achieving success in most patients.
Area of Science:
- Hepatology
- Infectious Diseases
- Interventional Radiology
Background:
- Pyogenic hepatic abscesses present a significant clinical challenge.
- Standard treatments like percutaneous drainage and intravenous antibiotics may be ineffective or contraindicated in some patients.
Purpose of the Study:
- To evaluate the efficacy and safety of intermittent hepatic artery antibiotic infusion for pyogenic hepatic abscesses.
- To identify potential complications associated with this therapeutic approach.
Main Methods:
- Eight patients with pyogenic hepatic abscesses, unresponsive to intravenous antibiotics and unsuitable for percutaneous drainage, were included.
- An injection catheter was placed into the common hepatic artery for intra-arterial antibiotic infusion (2-4 times daily).
- Antibiotic dosage was comparable to intravenous administration.
Main Results:
- Successful therapeutic effect was observed in six out of eight patients.
- The mean duration of intra-arterial infusion was 10.8 days, with a mean catheter indwelling time of 14.7 days.
- Broad-spectrum antibiotics demonstrated efficacy irrespective of abscess characteristics; one case of splenic infarction was the only significant complication.
Conclusions:
- Intermittent hepatic artery antibiotic infusion is a valuable alternative therapy for pyogenic hepatic abscesses.
- This method is particularly useful when percutaneous drainage is not feasible and intravenous antibiotic treatment has failed.
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