Assessment of the Outcome of USG Guided Percutaneous Drainage of Liver Abscess with and Without Administration of Intra Cavitary Meropenem & Urokinase

Abstract

Background: To evaluate the outcome of USG guided pigtail drainage of liver abscess with administration of intra cavitary meropenem and urokinase. Urokinase by its fibrinolytic action and meropenem with its time dependent local action enhances drainage of liver abscess. Materials and Methods Pig tail (9 Fr/10Fr) inserted under USG guidance for all patients with liver abscess > 5 cm , pus to be drained from the liver abscess and sent for culture sensitivity.  Instillation of intracavitary urokinase depends on the size of the abscess (2500 IU / cm of abscess diameter ) on the 1 st day , repeated at 8-hr intervals . Pigtail was clamped for 15 minutes and then unclamped.  On third day if the organisms in the pus shows culture sensitivity positive for meropenem, 500 mg of meropenem administered inside the abscess , repeated two more times after one and two weeks since the first administration. Results:The outcome of study is assessed by percentage of decrease in size of liver abscess at day 3,5,7,10 and 15 and the duration of hospital stay . It was found that using analysis of variance, p value is 0.032,chi square value 27.979 statistically significant difference exists. Conclusion: Patients treated with intra cavitary drugs meropenem and urokinase had shorter hospital stay (Day 7 (min)-Day 15(max). Control patients had longer hospital stay (>15 days). Combination of urokinase with meropenem shortens the hospital stay