Sandbox/Alejandro

Neutropenia and Cellular Immune Deficient Patients

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Neutropenia   ▸  Gram-Negative Bacteria   ▸  Gram-Positive Bacteria   ▸  Fungi Cellular Immune Deficiency Bacteria   ▸  Nocardia spp   ▸  Atypical mycobacteria Fungi   ▸  Cryptococcus spp   ▸  Histoplasma spp Viruses   ▸  Varicella-zoster virus   ▸  Herpes simplex virus   ▸  Cytomegalovirus

Gram-Negative Bacteria Preferred Regimen ▸ [[ Alternative Regimen ▸ ''''' Gram-Positive Bacteria Preferred Regimen Alternative Regimen ▸ [[ ▸ [ Fungi Preferred Regimen ▸ Liposomal Amphotericin B 3 mg/kg/day IV × 1-2 weeks OR ▸ Amphotericin B deoxycholate 0.7-1 mg/kg/day IV × 1-2 weeks OR ▸ Amphotericin B lipid complex 5 mg/kg/day IV × 1-2 weeks Alternative Regimen ▸ Voriconazole Caspofungin Nocardia spp Preferred Regimen ▸ TMP-SMX x 3-12 months Alternative Regimen 1 ▸ Sulfadiazine 2-4 g PO 1 dose FOLLOWED BY ▸ Sulfadiazine 2-4 g/day PO q4-8h x 3-12 months Alternative Regimen 1 ▸ Imipenem 250-500 mg IV q6-8h x 3-12 months Atypical mycobacteria Preferred Regimen ▸ [[ Alternative Regimen ▸ [[ Cryptococcus spp Preferred Regimen Moderate Severe to Severe Disease ▸ Liposomal Amphotericin B 3 mg/kg/day IV × 1-2 weeks OR ▸ Amphotericin B deoxycholate 0.7-1 mg/kg/day IV × 1-2 weeks OR ▸ Amphotericin B lipid complex 5 mg/kg/day IV × 1-2 weeks FOLLOWED BY ▸ Itraconazole 200 mg PO q12h x ≥12 months Mild to Moderate Disease ▸ Itraconazole 200 mg PO q12h x ≥12 months Adapted from Clin Infect Dis. 2007;45(7):807-25. Histoplasma spp Preferred Regimen ▸ Liposomal Amphotericin B 3 mg/kg/day x 1- 2 weeks OR ▸ Amphotericin B lipid complex 5 mg/kg/day x 1- 2 weeks FOLLOWED BY ▸ Itraconazole 200mg q8h x 3 days FOLLOWED BY ▸ Itraconazole 200mg q12h x 6-12 months Varicella-zoster virus Preferred Regimen ▸ Acyclovir 10 mg/kg IV (infusion over 1 hour) q8h x 7-10 days OR ▸ Famciclovir x 7-10 days OR ▸ Valacyclovir x 7-10 days Alternative Regimen ▸ [[ Herpes simplex virus Preferred Regimen ▸ Acyclovir 10 mg/kg IV (infusion over 1 hour) q8h x 7-10 days Alternative Regimen ▸ Famciclovir PO x 7 days OR ▸ Valacyclovir PO x 7 days Cytomegalovirus Preferred Regimen ▸ Ganciclovir x 21 days Alternative Regimen ▸ [[