Which antibiotics are recommended for the treatment of cavernous sinus thrombosis (CST)?

Updated: Jul 16, 2018
  • Author: Rahul Sharma, MD, MBA, FACEP; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Antibiotic therapy ideally is started after appropriate cultures but should not be delayed if difficulties exist in obtaining specimens. Antibiotics selected should be broad-spectrum, particularly active against S aureus, and capable of achieving high levels in the cerebrospinal fluid. With the recent increased prevalence of community-acquired MRSA, the emergency physician should consider additional coverage with intravenous antibiotics, such as vancomycin, if MRSA infection is suspected.

However, a case report and literature review by Naesens et al of community-acquired MRSA infections of the central nervous system, including cavernous sinus thrombosis, showed that patients treated with linezolid had a better outcome than those treated with vancomycin. [11]

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