Comparison of Empirical Intravenous Beta-Lactam Antimicrobials Plus Metronidazole and Oral Cefixime Plus Metronidazole Therapy for the Treatment of Liver Abscess: an Open Label Randomized Controlled Clinical Trial

What this Trial Is About

Liver abscess is a serious medical condition that requires prompt treatment using antimicrobials, with or without drainage of the abscess. This trial investigates the comparison between intravenous Beta-lactam antimicrobials plus Metronidazole and oral Cefixime plus Metronidazole for treating uncomplicated liver abscesses. The study aims to clarify the best antimicrobial approach, as current practices lack clear clinical trial evidence, especially regarding the use of intravenous antibiotics upfront. Participants diagnosed with liver abscess through imaging will be randomly assigned to one of two treatment groups. One group receives intravenous Beta-lactam antimicrobials (such as Piperacillin-Tazobactum, Ceftriaxone, Meropenem, or Imipenem-Cilastatin) plus intravenous Metronidazole for two weeks. The other group receives oral Cefixime plus oral Metronidazole for two weeks. Both groups will receive standard care, including drainage or aspiration when indicated, and will be followed for eight weeks. During the study, participants will be monitored for clinical cure, treatment failure, mortality, therapy duration, recurrence, adverse reactions, complications, hospital stay length, and readmissions over an eight-week period. Researchers will assess these outcomes to compare the effectiveness and safety of the two treatment strategies. The study includes regular evaluations and aims to provide evidence to guide antimicrobial use in liver abscess management.

Empirical Intravenous Beta-Lactam Plus Metronidazole Vs Oral Cefixime Plus Metronidazole for the Treatment of Liver Abscess