Neutropenic Fever Flashcards
(8 cards)
Neutropenic fever
1-Fever:
Single oral temperature ≥38.3°C (101°F)
Or ≥38.0°C (100.4°F) sustained over 1 hour
2-Neutropenia:
*Absolute neutrophil count (ANC) < 1500 cells/mm³:
1-1000-1500=mild
2-500-1000=moderete
3-Severe neutropenia: ANC < 500 cells/mm³ Or expected to fall below 500 cells/mm³ within 48 hours
Empirical antibiotics
A-Low risk group patients:
اللي هما مين؟
1- ANC >500 <7 days.
2-MASCc score >21
3-No complications
هتديهم ايه؟
Amox-clav 625mg 1+ Cipro 500mg 12
* Moxifloxacin 400mg 11
If Penicillin hypersensitivity:
Replace Amox-clav by Clindamycin 300mg 14
+ Cipro 500mg IV q12h
Empirical antibiotics
A-High risk group patients:
اللي هما مين؟
1- ANC <500 >7 days.
2-MASCc score <21
3- Any complications
هتديهم ايه؟
A-1st line monotherapy
(Must include antipseudomonas , quinolones or aminoglycosides not accipted in monotherapy)
التحشيشة (pipra +cmi)
التركيز ينزل النص كل مرة
الجرعة ابتدي ب٤ واختم ب ٤
Piperacillin-Tazobactam 4.5 gm 14
* Cefepime 2 gm IV 13
* Meropenem 1 gm Iv 13
* Imipenem-Cilastatin 500mg IV 1*4
B -2nd line dualantimicrobial
قول بتوع 1st line +aminoglycosides
Empirical antibiotics
Dose of aminoglycosides
*Gentamicin 5 mg/kg q24h
* Amikacin 15 mg/kg q1day
* Tobramycin 5 mg/kg q24h
Empirical antibiotics
Vancomycin is added if:
* Hypotension
* Skin & Soft tissue infection
* MRSA
* Catheter Related infection
* Blood culture for G-ve bacteria
Empirical antibiotics
Anerobes
*Not indicated in initial empiric therapy
*Indications :Sinusitis - Cellulitis - intra-abdominal infections - Pelvic infection
Empirical antibiotics
*Antifungal
1-Not indicated in initial empiric therapy
2-Only if Patients with Persistent fever > 7 days & high riskUsingAmphotericin B, Itraconazole.
3-Candida is the most common organism
MASCC score
يعني ايه ؟
Multinational Association for Supportive Care in Cancer) risk index score is used to identify low-risk febrile neutropenic patients
