Template:Neutropenic fever treatment: Difference between revisions
(Convert to AntibioticDose with disease=Neutropenic fever for SMW linking) |
(Add pediatric inpatient dosing section) |
||
| Line 16: | Line 16: | ||
*{{AntibioticDose|disease=Neutropenic fever|drug=Ciprofloxacin|dose=750mg PO q12hrs|context=Outpatient|population=Adult}} AND {{AntibioticDose|disease=Neutropenic fever|drug=Amoxicillin/Clavulanate|dose=875mg PO q12hrs x 7 days|context=Outpatient with Ciprofloxacin|population=Adult}} OR<ref name="antibiotics"></ref> | *{{AntibioticDose|disease=Neutropenic fever|drug=Ciprofloxacin|dose=750mg PO q12hrs|context=Outpatient|population=Adult}} AND {{AntibioticDose|disease=Neutropenic fever|drug=Amoxicillin/Clavulanate|dose=875mg PO q12hrs x 7 days|context=Outpatient with Ciprofloxacin|population=Adult}} OR<ref name="antibiotics"></ref> | ||
*[[Ciprofloxacin]] 750mg PO q12hrs AND {{AntibioticDose|disease=Neutropenic fever|drug=Clindamycin|dose=450mg PO q8hrs|context=Outpatient alt with Ciprofloxacin|population=Adult}} | *[[Ciprofloxacin]] 750mg PO q12hrs AND {{AntibioticDose|disease=Neutropenic fever|drug=Clindamycin|dose=450mg PO q8hrs|context=Outpatient alt with Ciprofloxacin|population=Adult}} | ||
===Pediatric Inpatient=== | |||
*{{AntibioticDose|disease=Neutropenic fever|drug=Cefepime|dose=50mg/kg IV q8hrs (max 2g)|context=Pediatric Inpatient|population=Pediatric}} '''OR''' | |||
*{{AntibioticDose|disease=Neutropenic fever|drug=Meropenem|dose=20mg/kg IV q8hrs (max 1g)|context=Pediatric Inpatient|population=Pediatric}} '''OR''' | |||
*{{AntibioticDose|disease=Neutropenic fever|drug=Piperacillin/Tazobactam|dose=80-100mg/kg IV q6-8hrs (max 4.5g)|context=Pediatric Inpatient|population=Pediatric}} | |||
*Add {{AntibioticDose|disease=Neutropenic fever|drug=Vancomycin|dose=15mg/kg IV q6hrs|context=Pediatric, MRSA/catheter|population=Pediatric}} for same indications as adults | |||
Latest revision as of 13:02, 20 March 2026
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 q8hrs or Ceftazidime 2g IV q8hrs OR
- Imipenem/Cilastatin 1g IV q8hrs or Meropenem 1g IV q8hrs OR
- Piperacillin/Tazobactam 4.5g IV q6hrs
- 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 x 7 days OR[1]
- Ciprofloxacin 750mg PO q12hrs AND Clindamycin 450mg PO q8hrs
Pediatric Inpatient
- Cefepime 50mg/kg IV q8hrs (max 2g) OR
- Meropenem 20mg/kg IV q8hrs (max 1g) OR
- Piperacillin/Tazobactam 80-100mg/kg IV q6-8hrs (max 4.5g)
- Add Vancomycin 15mg/kg IV q6hrs for same indications as adults
- ↑ 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