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Febrile Neutropenia
Drugs
16
Aviation
4th Grade
05/01/2014

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Cards

Term
Initial Regimen Low Risk
Definition
oral antibiotics are a possibility: Ciprofloxacin + amoxicillin/Clavulanate
Term
Initial Regimen High Risk
Definition
IV antibiotics are needed: Monotherapy vs dual/combo therapy, Addition of vancomycin
Term
Oral Preferred Regimen
Definition
Ciprofloxacin 500-750 mg PO BID PLUS Amoxicillin/Clavulanate 500 mg PO q 8 hours
Term
Appropriate IV Monotherapy
Definition
Ceftazidime or Cefepime or Carbapenem (nort Ertapenem) or Piperacillin/tazobactam
Term
Appropriate Dual IV Therapy
Definition
Aminoglycoside PLUS zosyn OR Cefepime or ceftazidime OR carbapenem; Do Not combine 2 beta lactams
Term
Vancomycin alternatives
Definition
Linezolid, Daptomycin, Ceftaroline
Term
not recommended as empiric antifungal therapy; does not cover Aspergillus spp and some candida spp
Definition
Fluconazole (Diflucan)
Term
drug of choice for Aspergillus spp; may consider when patient at risk for Aspergillus spp
Definition
Voriconazole (Vfend)
Term
only echinocandin approved for use in NF; active against Candida and Aspergillus spp; similar to amph B in breakthrough fungal infection rates and fever resolution, but less drug toxicities and ADRs
Definition
Caspofungin (Cancidis)
Term
broad anti-fungal spectrum; lipid formulations preferred over conventional, less toxic, but more expensive
Definition
Amphotericin B
Term
Antibiotic Prophylaxis
Definition
Quinolones; TMP/SMX
Term
decrease febrile episodes/infections, may select for resistant gram-negative rods and MRSA
Definition
Quinolones
Term
decreased infection rates, but NOT mortality; ADR: bone marrow suppression, fungal overgrowth; not active vs Pseudomonas, may select out of resistance
Definition
TMP/SMX (Bactrim)
Term
Anti-fungal Prophylaxis
Definition
Azoles, Enchinocandins, Amphotericin
Term
Azoles
Definition
fluconazole, voriconazole, posaconazole
Term
Enchinocandins
Definition
capofungin, micafungin
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