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Prompt empirical antimicrobial with or without percutaneous aspiration or drainage is therapeutic. The rational for using empirical intravenous broad-spectrum antimicrobials upfront instead of oral Fluoroquinolone or Cephalosporin is contentious. In this double blind randomized control clinical trial 69 participants received Ciprofloxacin (500\u00a0mg q 12 hourly) and 71 participants received Cefixime (200\u00a0mg q 12 hourly) orally for 2\u00a0weeks. Both the group received oral Metronidazole (800\u00a0mg q 8 hourly) for 2\u00a0weeks and percutaneous drainage or aspiration of the abscess was done as per indication and followed-up for 8\u00a0weeks. Out of 140 participants, 89.3% (N\u2009=\u2009125) achieved clinical cure, 59 (85.5%) in Ciprofloxacin group and 66 (93%) in Cefixime group (p\u2009=\u20090.154). Mean duration of antimicrobial therapy was 16.2\u2009\u00b1\u20094.3\u00a0days, 15.1\u2009\u00b1\u20094.5\u00a0days in Ciprofloxacin group and 16.0\u2009\u00b1\u20094.2\u00a0days in Cefixime group (p\u2009=\u20090.223). Total 15 (10.7%) participants had treatment failure, 10 (14.5%) in Ciprofloxacin group and 5 (7.0%) in Cefixime group (p\u2009=\u20090.154). The most common reason for treatment failure was need of prolong (&gt;\u20094\u00a0weeks) antimicrobial therapy due to persistent hepatic collection requiring drainage, which was significantly (p\u2009=\u20090.036) higher in Ciprofloxacin (14.5%, N\u2009=\u200910) group, compared to the Cefixime (4.2%, N\u2009=\u20093) group. In conclusion, both, the Ciprofloxacin or Cefixime plus Metronidazole for duration of 2\u20133\u00a0weeks were efficacious as empirical oral antimicrobial regimen along with prompt percutaneous drainage or aspiration for the treatment of uncomplicated liver abscess with similar efficacy. Oral Cefixime was better than Ciprofloxacin in term of lesser chance of treatment failure due to persistent collection which is required to be investigated further in larger clinical trial.<\/jats:p><jats:p><jats:bold>Trial registration<\/jats:bold>: clinicaltrials.gov PRS ID: NCT03969758, 31\/05\/2019.<\/jats:p>","DOI":"10.1038\/s41598-024-59607-1","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T06:01:39Z","timestamp":1716184899000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy of empirical Ciprofloxacin or Cefixime plus Metronidazole therapy for the treatment of liver abscess: a randomized control clinical trial"],"prefix":"10.1038","volume":"14","author":[{"given":"Lakshmi","family":"Priya G","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deba Prasad","family":"Dhibar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atul","family":"Saroch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Navneet","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vishal","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nipun","family":"Verma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sreedhara Bettadahally","family":"Chaluvashetty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Prakash","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harsimran","family":"Kaur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,20]]},"reference":[{"issue":"3","key":"59607_CR1","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/S0891-5520(05)70120-3","volume":"14","author":"EC Johannsen","year":"2000","unstructured":"Johannsen, E. 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