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Ciprofloxacin recommended for hepatic cyst infection

In a recent study, researchers in the Netherlands found that hepatic cyst infection recurrence was common and recommended oral ciprofloxacin as initial treatment for the infection.

“Currently, the treatment of hepatic cyst infection is undefined,” researcher Marten Lantinga, MD, of Radboud University Medical Center in the Netherlands, told Healio.com/Hepatology. “Two criteria should be met for an effective antimicrobial treatment: the ability to reach an adequate intracystic concentration and bactericidial activity against cyst infection pathogens.

Marten Lantinga

Lantinga and colleagues chose 54 hepatic cyst infection cases from 41 studies to analyze patient characteristics, treatment and follow-up data to determine the best course of treatment for a hepatic cyst infection. Thirty-nine percent of the cases analyzed included male patients, and the mean age of the patients was 63 ± 12 years.

Overall, researchers identified initial therapy for hepatic cyst infection to be either antimicrobial (56%), percutaneous (31%) or a surgical treatment (13%). Twenty percent of final treatment regimens were antimicrobials, 46% were percutaneous and 33% were surgery treatment-related. Of the microbial regimens, there were 23 different combinations and most antibiotic classes were quinolones and cephalosporins (34% for both). The antimicrobial therapy failed more (70%) among the patients compared with the percutaneous (37%) or surgical (27%) treatment. Initial therapy failures were found in 50% of all cases, according to the research.

Twenty percent of all patients experienced recurrence at a median time of 8 weeks. Hepatic cyst-related death occurred in 9% of patients.

“This study is important as it provides an evidence-based treatment advice for hepatic cyst infection,” Lantinga said. “Treatment with oral ciprofloxacin, guided by culture and sensitivity results, is recommended as first line therapy. Percutaneous hepatic cyst drainage is the alternative for those failing antimicrobial treatment.” – by Melinda Stevens  

Disclosure: The researchers report no relevant financial disclosures.