In patients with autosomal dominant polycystic kidney disease (ADPKD), liver cyst infection is a serious complication defined by a specific clinical and laboratory profile. Prompt recognition and structured management are essential to achieving an adequate clinical response.
This protocol applies to ADPKD patients with suspected liver cyst infection presenting with all of the following:
The primary clinical target is a response within 48–72 hours: temperature falling below 38.0°C and a measurable decrease in C-reactive protein.
Management is built around empirical intravenous antibiotic therapy, with a structured transition to oral therapy once clinical stabilisation is achieved.
The specific antibiotic classes, criteria for switching to oral therapy, and the required minimum treatment duration are all defined in the full protocol below.
DOI: 10.1016/j.kint.2024.07.010
Empirical antibiotic treatment of liver cyst infections should target gram-negative bacteria in the Enterobacteriaceae family.
Empirical antibiotic treatment of liver cyst infections should be initiated with a third-generation intravenous (i.v.) cephalosporin with or without a fluoroquinolone. After clinical stabilization, i.v. therapy can be switched to an oral fluoroquinolone, with adjustment according to culture results when available.
Duration of antibiotic therapy should be ≥4 weeks for liver cyst infection. Longer treatment periods may be required based on the response to therapy.
A clinical response to antibiotics is expected within 48–72 hours and can be monitored with clinical parameters (i.e., temperature, BP, heart rate, and ventilation rate) in combination with laboratory evaluations (i.e., CRP and leukocyte count).
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