{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T13:57:51Z","timestamp":1785592671367,"version":"3.56.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Microbiol Infect Dis"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>We sought to describe current perceptions and attitudes to management of of brain abscess (BA) or sub-\/extra-dural empyema (SDE\/EDE) in the United Kingdom (UK) to compare this to the 2024 European Society of Clinical Microbiology and Infectious Diseases BA guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a web-based survey of infection specialists (IS) and neurosurgeons (NS) at neurosurgical centres across the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      IS from 27\/39 (69%) and NS from 18\/39 (46%) UK neurosurgical centres participated. All IS reported use of a third-generation cephalosporin as empirical antibiotic therapy, 57\/61 (93%) alongside metronidazole, 19\/57 (33%) preferring oral metronidazole throughout treatment. Most IS (46\/60, 76.7%) consider switching to oral antibiotics prior to completing 6 weeks intravenous (IV) therapy, with 33\/46 (71.7%) considering a 1\u20132 week minimum IV duration if there has been neurosurgical intervention. Most NS (22\/25, 88%) agreed that neurosurgical intervention is indicated for any BA\u2009\n                      <jats:italic>\u2265<\/jats:italic>\n                      \u20092.5\u00a0cm diameter, most (21\/25, 84%) favouring burr hole aspiration. For SDE\/EDE only 12\/25 (48%) of NS would surgically intervene in all circumstances. Most IS and NS (72\/76, 94.7%) would consider intrathecal antibiotics in ruptured BA with ventriculitis; only 11\/74 (14%) reported experience with intracavitary antimicrobials. 44\/74 (59%) reported using steroids in BA, while 20\/74 (27%) reported avoiding steroids. Reimaging was favoured at 2\u20133 weeks by NS, IS favoured 4\u20138 weeks, or not reimaging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There are areas of marked variation in the management of BA and SDE\/EDE in the UK, particularly early switch from IV to oral antibiotics, SDE surgery, repeat brain imaging and use of steroids.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10096-026-05522-4","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:24:28Z","timestamp":1777883068000},"page":"2521-2529","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of community-acquired brain abscess and intracranial empyema: a survey of UK neurosurgical centres"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7448-1795","authenticated-orcid":false,"given":"Carmen Thompson","family":"Perea","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7865-159X","authenticated-orcid":false,"given":"Holly","family":"Roy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2417-346X","authenticated-orcid":false,"given":"James","family":"Hatcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"de Saram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7398-814X","authenticated-orcid":false,"given":"Jacob","family":"Bodilsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0566-1820","authenticated-orcid":false,"given":"Peter","family":"Whitfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8836-7613","authenticated-orcid":false,"given":"William","family":"Singleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Wildman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0904-9946","authenticated-orcid":false,"given":"Michelle M.","family":"Kameda-Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2927-7914","authenticated-orcid":false,"given":"Eliza","family":"Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"5522_CR1","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1016\/j.jinf.2020.03.011","volume":"80","author":"CA Darlow","year":"2020","unstructured":"Darlow CA, McGlashan N, Kerr R, Oakley S, Pretorius P, Jones N et al (2020) Microbial aetiology of brain abscess in a UK cohort: Prominent role of Streptococcus intermedius. J Infect 80:623\u2013629. https:\/\/doi.org\/10.1016\/j.jinf.2020.03.011","journal-title":"J Infect"},{"key":"5522_CR2","doi-asserted-by":"publisher","unstructured":"Guy RL, Coelho J, Moganeradj K, Gil E, Sabtu N, Brown CS et al (2025) P-921. A decade of changing incidence and microbial aetiology of brain abscesses in England between 2014 and 2023. Open Forum Infect Dis [Internet] 2025 1 [cited 2025 24];12:ofae631.1112. https:\/\/doi.org\/10.1093\/ofid\/ofae631.1112","DOI":"10.1093\/ofid\/ofae631.1112"},{"key":"5522_CR3","doi-asserted-by":"publisher","unstructured":"Allen VB, Raslan A, Muuli AM, Alkhafaji NY, Bechman K, Wijeweera KDDS et al (2025) Epidemiology of brain abscess: a retrospective cohort from a neurosurgical tertiary referral center in England. Open Forum Infect Dis [Internet] 2025 1 [cited 2025 18];12:ofaf655. https:\/\/doi.org\/10.1093\/ofid\/ofaf655","DOI":"10.1093\/ofid\/ofaf655"},{"key":"5522_CR4","doi-asserted-by":"publisher","unstructured":"BodilsenJ, D\u2019Alessandris QG, Humphreys H, Iro MA, Klein M, Last K et al (2024) European society of clinical microbiology and infectious diseases guidelines on diagnosis and treatment of brain abscess in children and adults. Clin Microbiol Infect [Internet] 2024 1 [cited 2025 30];30:66\u201389. https:\/\/doi.org\/10.1016\/j.cmi.2023.08.016","DOI":"10.1016\/j.cmi.2023.08.016"},{"key":"5522_CR5","doi-asserted-by":"publisher","unstructured":"BodilsenJ, Dalager-Pedersen M, van de Beek D, Brouwer MC, Nielsen H (2020) Incidence and mortality of brain abscess in Denmark: a nationwide population-based study. Clin Microbiol Infect [Internet] 2020 1 [cited 2023 22];26:95\u2013100. https:\/\/doi.org\/10.1016\/j.cmi.2019.05.016","DOI":"10.1016\/j.cmi.2019.05.016"},{"key":"5522_CR6","doi-asserted-by":"publisher","unstructured":"Bodilsen J, Dalager-Pedersen M, van de Beek D, Brouwer MC, Nielsen H (2020) Long-term mortality and epilepsy in patients after brain abscess: a nationwide population-based matched cohort study. Clin Infect Dis [Internet] 2020 1 [cited 2025 19];71:2825\u201332. https:\/\/doi.org\/10.1093\/cid\/ciz1153","DOI":"10.1093\/cid\/ciz1153"},{"key":"5522_CR7","doi-asserted-by":"publisher","unstructured":"Brouwer MC, Coutinho JM, van de Beek D (2014) Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology 82:806\u2013813. https:\/\/doi.org\/10.1212\/WNL.0000000000000172","DOI":"10.1212\/WNL.0000000000000172"},{"key":"5522_CR8","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1007\/s15010-018-1182-9","volume":"46","author":"JD Widdrington","year":"2018","unstructured":"Widdrington JD, Bond H, Schwab U, Price DA, Schmid ML, McCarron B et al (2018) Pyogenic brain abscess and subdural empyema: presentation, management, and factors predicting outcome. Infection 46:785\u2013792. https:\/\/doi.org\/10.1007\/s15010-018-1182-9","journal-title":"Infection"},{"key":"5522_CR9","doi-asserted-by":"publisher","unstructured":"Iro MA, Goldacre MJ, Goldacre R (2023) Central nervous system abscesses and empyemas in England: epidemiological trends over five decades. Journal of Infection [Internet] 2023 1 [cited 2023 1];86:309\u2013315. https:\/\/doi.org\/10.1016\/j.jinf.2023.01.040","DOI":"10.1016\/j.jinf.2023.01.040"},{"key":"5522_CR10","doi-asserted-by":"publisher","unstructured":"Accorsi EK, Hall M, Hersh AL, Shah SS, Schrag SJ, Cohen AL (2023) Notes from the field: update on pediatric intracranial infections\u2009\u2013\u200919 states and the district of Columbia, January 2016-March 2023. MMWR Morb Mortal Wkly Rep 72:608\u2013610. https:\/\/doi.org\/10.15585\/mmwr.mm7222a5","DOI":"10.15585\/mmwr.mm7222a5"},{"key":"5522_CR11","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1186\/s12887-024-05082-6","volume":"21","author":"Y Liu","year":"2024","unstructured":"Liu Y, Bai Z, Yang T, Yuan B, Han Y, Xiang Y et al (2024) Changes in the epidemiology of pediatric brain abscesses pre- and post-COVID-19 pandemic: a single-center study. BMC Pediatr 21:24:600. https:\/\/doi.org\/10.1186\/s12887-024-05082-6","journal-title":"BMC Pediatr"},{"key":"5522_CR12","doi-asserted-by":"publisher","unstructured":"Helweg-Larsen J, Astradsson A, Richhall H, Erdal J, Laursen A, Brennum J (2012) Pyogenic brain abscess, a 15 year survey. BMC Infect Dis 12:332. https:\/\/doi.org\/10.1186\/1471-2334-12-332","DOI":"10.1186\/1471-2334-12-332"},{"key":"5522_CR13","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1017\/s0317167100039159","volume":"23","author":"S Shahzadi","year":"1996","unstructured":"Shahzadi S, Lozano AM, Bernstein M, Guha A, Tasker RR (1996) Stereotactic management of bacterial brain abscesses. Can J Neurol Sci 23:34\u201339. https:\/\/doi.org\/10.1017\/s0317167100039159","journal-title":"Can J Neurol Sci"},{"key":"5522_CR14","doi-asserted-by":"publisher","first-page":"e6359","DOI":"10.1097\/MD.0000000000006359","volume":"96","author":"X Yu","year":"2017","unstructured":"Yu X, Liu R, Wang Y, Zhao H, Chen J, Zhang J et al (2017) May stereotactic intracavity administration of antibiotics shorten the course of systemic antibiotic therapy for brain abscesses? Med (Baltim) 96:e6359. https:\/\/doi.org\/10.1097\/MD.0000000000006359","journal-title":"Med (Baltim)"},{"key":"5522_CR15","doi-asserted-by":"publisher","first-page":"e317","DOI":"10.1016\/j.wneu.2022.06.041","volume":"165","author":"S Hirata","year":"2022","unstructured":"Hirata S, Kobayashi M, Ujihara M, Takabatake K, Wakiya K, Fujimaki T (2022) Aspiration Surgery with Appropriate Antibiotic Treatment Yields Favorable Outcomes for Bacterial Brain Abscess. World Neurosurg 165:e317\u2013e324. https:\/\/doi.org\/10.1016\/j.wneu.2022.06.041","journal-title":"World Neurosurg"},{"key":"5522_CR16","doi-asserted-by":"publisher","unstructured":"van der Velden FJS, Battersby A, Pareja-Cebrian L, Ross N, Ball SL, Emonts M (2019) Paediatric focal intracranial suppurative infection: a UK single-centre retrospective cohort study. BMC Pediatr 19:130. https:\/\/doi.org\/10.1186\/s12887-019-1486-7","DOI":"10.1186\/s12887-019-1486-7"},{"key":"5522_CR17","doi-asserted-by":"publisher","unstructured":"Fiorindi A, Marton E, Gioffr\u00e8 G, Biroli A, Basaldella L, Fontanella MM et al (2020) New perspectives in the endoscopic treatment of brain purulent collections: targets, techniques, results in a case series, and overview of the literature. Acta Neurochir [ Internet] 2020 1 [cited 2025 30];162:2867\u20132874. https:\/\/doi.org\/10.1007\/s00701-020-04301-0","DOI":"10.1007\/s00701-020-04301-0"},{"key":"5522_CR18","doi-asserted-by":"publisher","unstructured":"Evans TJ, Jawad S, Kalyal N, Nadarajah A, Amarouche M, Stapleton S et al (2022) Retrospective review of the epidemiology, microbiology, management and outcomes of intra-cranial abscesses at a neurosurgical tertiary referral centre, 2018\u20132020. Ann Clin Microbiol Antimicrob [Internet] 2022 27 [cited 2025 30];21:58. https:\/\/doi.org\/10.1186\/s12941-022-00550-2","DOI":"10.1186\/s12941-022-00550-2"},{"key":"5522_CR19","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1007\/s10096-020-04032-1","volume":"40","author":"J Bodilsen","year":"2021","unstructured":"Bodilsen J, Tattevin P, Tong S, Naucler P, Nielsen H (2021) Treatment of community-acquired bacterial brain abscess: a survey among infectious diseases specialists in France, Sweden, Australia, and Denmark. Eur J Clin Microbiol Infect Dis 40:255\u2013260. https:\/\/doi.org\/10.1007\/s10096-020-04032-1","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"5522_CR20","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1017\/cjn.2022.299","volume":"50","author":"MM Kameda-Smith","year":"2023","unstructured":"Kameda-Smith MM, Ragulojan M, Hart S, Duda TR, MacLean MA, Chainey J et al (2023) A Canadian National Survey of the Neurosurgical Management of Intracranial Abscesses. Can J Neurol Sci 50:679\u2013686. https:\/\/doi.org\/10.1017\/cjn.2022.299","journal-title":"Can J Neurol Sci"},{"key":"5522_CR21","unstructured":"SBNS Neurosurgical Units in the UK [Internet]. [cited 2025 29]; https:\/\/www.sbns.org.uk\/about-us\/neurosurgical-units-in-the-uk.html"},{"key":"5522_CR22","unstructured":"The Brain & Spine Foundation List of Neurological Centres and Services in the UK [Internet] (2022) ; https:\/\/www.brainandspine.org.uk\/wp-content\/uploads\/2022\/10\/BSF-List-of-Neurocentres-UK.pdf"},{"key":"5522_CR23","doi-asserted-by":"publisher","first-page":"286","DOI":"10.3171\/2025.2.PEDS24227","volume":"136","author":"A Edwards-Bailey","year":"2025","unstructured":"Edwards-Bailey A, Rybka N, Hollingworth MA, Heard F, Kumaria A, Macarthur DC et al (2025) Community-acquired cerebral abscess and intracranial empyemas in children: a prospective cohort study. J Neurosurg Pediatr 136:286\u2013295. https:\/\/doi.org\/10.3171\/2025.2.PEDS24227","journal-title":"J Neurosurg Pediatr"},{"key":"5522_CR24","doi-asserted-by":"publisher","unstructured":"Germiller JA, Monin DL, Sparano AM, Tom LWC (2006) Intracranial Complications of Sinusitis in Children and Adolescents and Their Outcomes. Arch Otolaryngol Head Neck Surg [Internet] 2006 1 [cited 2025 29];132:969\u201376. https:\/\/doi.org\/10.1001\/archotol.132.9.969","DOI":"10.1001\/archotol.132.9.969"},{"key":"5522_CR25","doi-asserted-by":"publisher","unstructured":"Hall B, Duddy JC, Apostolopoulou K, David R, Kurzbuch A, Nadkarni A et al (2023) Intracranial empyemas in the COVID-19 era: a new phenomenon? A paediatric case series and review of the literature. Pediatr Neurosurg 30. https:\/\/doi.org\/10.1159\/000531753","DOI":"10.1159\/000531753"},{"key":"5522_CR26","doi-asserted-by":"publisher","unstructured":"Sexton GP, Nae A, Cleere EF, O\u2019Riordan I, O\u2019Neill JP, Lacy PD et al (2022) Concurrent management of suppurative intracranial complications of sinusitis and acute otitis media in children. Int J Pediatr Otorhinolaryngol [ Internet] 2022 1 [cited 2025 28];156:111093. https:\/\/doi.org\/10.1016\/j.ijporl.2022.111093","DOI":"10.1016\/j.ijporl.2022.111093"}],"container-title":["European Journal of Clinical Microbiology &amp; Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-026-05522-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10096-026-05522-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-026-05522-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T13:11:49Z","timestamp":1785589909000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10096-026-05522-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["5522"],"URL":"https:\/\/doi.org\/10.1007\/s10096-026-05522-4","relation":{},"ISSN":["0934-9723","1435-4373"],"issn-type":[{"value":"0934-9723","type":"print"},{"value":"1435-4373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"assertion":[{"value":"22 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study \u201cSurvey on the management of intracranial suppurative infection\u201d was approved by the Observational\/Interventions Research Ethics Committee of the London School of Hygiene and Tropical Medicine, reference 31186.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Participation in this survey was voluntary. Participant information was provided and the choice to participate in the survey was taken as consent.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}