Template:Neutropenic fever treatment: Difference between revisions
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Therapy is aimed at treating multiple flora that include [[Gram Negatives]], [[Gram Positive Bacteria]], [[Pseudomonas]] and if there is an indwelling catheter or high risk, then [[MRSA]]. | ''Therapy is aimed at treating multiple flora that include [[Gram Negatives]], [[Gram Positive Bacteria]], [[Pseudomonas]] and if there is an indwelling catheter or high risk, then [[MRSA]].'' | ||
===Inpatient=== | ===Inpatient=== | ||
*Monotherapy appears to be as good as dual-drug therapy<ref name="antibiotics">Friefeld AG et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the IDSA. Clin Infect Dis. 2011; 52(4):e56-93 [http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/FN.pdf fulltext]</ref> | *Monotherapy appears to be as good as dual-drug therapy<ref name="antibiotics">Friefeld AG et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the IDSA. Clin Infect Dis. 2011; 52(4):e56-93 [http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/FN.pdf fulltext]</ref> | ||
Latest revision as of 21:32, 11 September 2024
Therapy is aimed at treating multiple flora that include Gram Negatives, Gram Positive Bacteria, Pseudomonas and if there is an indwelling catheter or high risk, then MRSA.
Inpatient
- Monotherapy appears to be as good as dual-drug therapy[1]
- Cefepime 2g IV q8hr or Ceftazidime 2g IV q8hr OR
- Imipenem/Cilastin 1gm IV q8hr or Meropenem 1gm IV q8hr OR
- Piperacillin/Tazobactam 4.5gm IV q 6hr
- Consider adding Vancomycin to above regimen for:[2]
- Severe mucositis
- Signs of catheter site infection
- Fluoroquinolone prophylaxis was recently used against gram-negative bacteremia
- Hypotension is present
- Institutions with hospital-associated MRSA
- Patient has known colonization with resistant gram-positive organisms
Outpatient
- Ciprofloxacin 750mg PO q12hrs AND Amoxicillin/Clavulanate 875mg PO q12hrs x7d OR[1]
- Ciprofloxacin 750mg PO q12hrs AND Clindamycin 450mg PO q8hrs
- ↑ 1.0 1.1 Friefeld AG et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the IDSA. Clin Infect Dis. 2011; 52(4):e56-93 fulltext
- ↑ Hughes WT, Armstrong D, Bodey GP, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clinical Infectious Disease 2002; 34:730-751