Management protocols for Lung Abscess in Uganda

Clinical Features

Cough with purulent sputum, foul-smelling breath (halitosis). Sweating with chills and fever. Finger clubbing.

Investigations

Chest X-ray: Early stages (consolidation), later stages (cavity with a fluid level). Sputum microscopy and culture.

Initial Management

Benzylpenicillin 1-2 MU IV/IM every 4-6 hours (Child: 50,000-100,000 IU/kg per dose) PLUS metronidazole 500 mg IV every 8-12 hours.

Maintenance

Once improved, switch to oral metronidazole 400 mg every 12 hours PLUS Amoxicillin 500 mg-1 g 8 hourly. Continue for 4-8 weeks.

Supportive

Postural drainage/physiotherapy. Surgical drainage may be necessary.