<prompt> Answer this question truthfullyWhat is the appropriate medical treatment for cavernous sinus thrombosis?  <response>: <reason> Cavernous sinus thrombosis is considered a medical emergency. Duration of therapy is usually a total of 3-4 weeks. More prolonged administration of antimicrobial therapy total of 6-8 weeks may be indicated among patients who are suspected to have developed complications e.g. suppurative intracranial disease. ENT surgery must be consulted to evaluate the need of surgical drainage e.g. sphenoidotomy if sphenoid sinus infection is the primary cause. Septic thrombosis of cavernous or dural venous sinus1. Empiric antimicrobial therapy Preferred regimen: Vancomycin 3045 mgkg IV q812h for 3-4 weeks OR Nafcillin 2 g IV q4h for 3-4 weeks OR Oxacillin 2 g IV q4h for 3-4 weeks AND Ceftriaxone 2 g IV q12h for 3-4 weeks OR Cefotaxime 812 gday IV q46h for 3-4 weeks AND Metronidazole 7.5 mgkg IV q6h 3-4 weeks Note 1: If risk of MRSA is high, Vancomycin should be administered instead of either nafcillin or oxacillin Note 2: The optimal duration of therapy remains unclear2. Specific anatomic considerations 2.1 Cavernous sinus Preferred regimen: Vancomycin 3045 mgkg IV q812h for 3-4 weeks AND Ceftriaxone 2 g IV q12h for 3-4 weeks OR Cefotaxime 812 gday IV q46h for 3-4 weeks AND Metronidazole 7.5 mgkg IV q6h for 3-4 weeks Note: Daptomycin 812 mgkg IV q24h OR Linezolid 600 mg IV q12h could be considered for patients unable to tolerate vancomycin2.2 Lateral sinus Preferred regimen: Cefepime 2 g IV q8h for 3-4 weeks AND Metronidazole 500 mg IV q8h for 3-4 weeks AND Vancomycin 15-20 IV mgkg for 3-4 weeks Alternative regimen: Meropenem 1-2 g IV q8h 3-4 weeks AND Linezolid 600 mg IV q12h 3-4 weeks2.3 Superior sagittal sinus Preferred regimen: Ceftriaxone 2 g IV q12h for 3-4 weeks AND Vancomycin 1520 mgkg for 3-4 weeks AND Dexamethasone 10 mg IV q6h continued until symptomatic improvement and tailed gradually over several weeks Alternative regimen: Meropenem 12 g IV q8h for 3-4 weeks AND Vancomycin 1520 mgkg for 3-4 weeks AND Dexamethasone 10 mg IV q6h continued until symptomatic improvement and tailed gradually over several weeks3. Pathogen-directed antimicrobial therapy Staphylococcus aureus, methicillin-resistant MRSA Preferred regimen: Vancomycin 1520 mgkgdose IV q812h for 46 weeks Alternative regimen: Linezolid 600 mg POIV q12h for 46 weeks OR TMP-SMX 5 mgkgdose POIV q812h for 46 weeks Pediatric dose: Vancomycin 15 mgkgdose IV q6h 46 weeks OR Linezolid 10 mgkgdose POIV q8h 46 weeks Note 1: Surgical evaluation for incision and drainage of contiguous sites of infection or abscess is recommended whenever possible Note 2: Consider the addition of Rifampin 600 mg qd or 300450 mg bid to vancomycin 