Antibiotics for brain abscesses in people with cyanotic congenital heart disease

Abstract

Background: Brain abscess is a focal, intracerebral infection that begins as a localized area of brain infection and develops into a collection of pus surrounded by a well-vascularized capsule. People with cyanotic congenital heart disease are at risk of developing brain abscess.

Objectives: To evaluate the effectiveness of antibiotic regimens for treating brain abscess in people with cyanotic congenital heart disease.

Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library 2006, Issue 2, MEDLINE (January 1966 to June 2006), EMBASE (January 1998 to June 2006), and LILACS (accessed in June 2006). No language or publication restrictions were used.

Selection criteria: Randomized controlled trials that reported clinically meaningful outcomes and presented results on an intention to treat basis, irrespective of blinding, publication status, or language.

Data collection and analysis: Data were to be extracted, unblinded, by the two reviewers independently. The search identified 489 articles of which 152 were articles on brain abscess. Most of the articles were case series and case reports.

Main results: No studies that met the inclusion criteria were identified.

Authors' conclusions: There are no randomized controlled trials about the effectiveness of antibiotic regimens for treating people with cyanotic congenital heart disease who developed a brain abscess. Currently, the antibiotic regimens used are based on previous retrospective studies and clinical experience. There is a need for a well designed multicentre randomized controlled trial to evaluate the effects of different antibiotic regimens.