Fluoroquinolone is an alternative treatment for Klebsiella pneumoniae liver abscess and its impact on length of stay.

Abstract Klebsiella pneumoniae liver abscess (KPLA) is an endemic disease in East Asia. Patients with KPLA usually require prolonged intravenous β-lactams therapy and hospitalization. Fluoroquinolones have high oral bioavailability and the potential to shorten the duration of intravenous therapy. Here, we aimed to investigate the feasibility of fluoroquinolones as an alternative treatment for KPLA in Taiwan. Consecutive patients with KPLA in a medical center in Taiwan between July 2012 and August 2019 were retrospectively enrolled. Clinical characteristics and outcomes were compared between cases treated with β-lactams and fluoroquinolones. Multivariate logistic regression model and propensity-score adjusted analysis were performed to identify independent risk factors for prolonged hospitalization. A total of 234 patients with KPLA were identified during the study period. Most patients received β-lactams (n = 199 [85.0%]), while only 35 (15.0%) received fluoroquinolones as the major therapy. Fluoroquinolones had similar clinical efficacy to β-lactams, even in critically ill patients. Patients treated with fluoroquinolones had a shorter intravenous antibiotics duration (18.9 ± 7.6 versus 28.5 ± 14.7, p 14 days in all patients, and also for hospital LOS > 21 days in critically ill patients. In conclusion, fluoroquinolone was an effective alternative treatment for KPLA that resulted in a shorter duration of intravenous therapy and hospital stay.