Sandbox/Alejandro: Difference between revisions
< Sandbox
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==Neutropenic Patients== | ==Neutropenic Patients== | ||
* Patients with neutropenia require an antimicrobial therapy with a broader coverage. | |||
* The duration of antimicrobial therapy should be individualized in accordance with patient's clinical response. | |||
{| style="border: 2px solid #696969;" | |||
|+ <SMALL>''Recommended Duration of Antimicrobial Therapy Based on the Microorganism.''</SMALL> | |||
| style="background: #A5B2D6; border: 0px solid #696969; padding: 0 5px; width: 200px"| '''''Microorganism''''' || style="background: #A5B2D6; border: 0px solid #696969; padding: 0 5px; width: 200px" | '''Duration of Therapy''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left | ▸ '''''[[Gram-negative Bacteria]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' 7-14 days''''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left | ▸ '''''[[Gram-positive Bacteria]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' 7-10 days''''' | |||
|- | |||
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5" align=left | ▸ '''''[[Fungi]]''''' || style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ''''' Until clinical resolution''''' | |||
|- | |||
|} | |||
<SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL> | <SMALL><font color="#FF4C4C">'''▸ Click on the following categories to expand treatment regimens.'''</font></SMALL> | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Preferred Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Meropenem]] 0.5-1 g IV q8h (infuse over 15-30 min or in bolus over 3-5 min)'''''<br> OR <br> ▸ '''''[[Imipenem/cilastatin]] 1-2 g/day divided q6-8h (max: 50mg/kg/day)'''''<br> OR <br> ▸ '''''[[Cefepime]] 2g IV q8h'''''<br> OR <br> ▸ ''''' [[Piperacillin/tazobactam]] | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Meropenem]] 0.5-1 g IV q8h (infuse over 15-30 min or in bolus over 3-5 min)'''''<br> OR <br> ▸ '''''[[Imipenem/cilastatin]] 1-2 g/day divided q6-8h (max: 50mg/kg/day)'''''<br> OR <br> ▸ '''''[[Cefepime]] 2g IV q8h'''''<br> OR <br> ▸ '''''[[Ceftazidime]] 2g IV q8h'''''<br> OR <br> ▸ ''''' [[Piperacillin/tazobactam]] 3.375 g IV q6–8h''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen 1 ''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen 1 ''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Amikacin]] '''''<br> OR <br> ▸ '''''[[Gentamicin]] ''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |PLUS | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |PLUS | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Cefepime]] 2g IV q8h'''''<br> OR <br> ▸ ''''' [[Piperacillin/tazobactam]] | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ '''''[[Cefepime]] 2g IV q8h'''''<br> OR <br> ▸ ''''' [[Piperacillin/tazobactam]] 3.375 g IV q6–8h (max 24 g/day)''''' | ||
|- | |- | ||
| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen 2 ''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen 2 ''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ ''''' [[Piperacillin/tazobactam]] | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |▸ ''''' [[Piperacillin/tazobactam]] 3.375 g IV q6–8h (max 24 g/day)''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |PLUS | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left |PLUS | ||
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| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Linezolid]] 600 mg IV/PO q12h'''''<BR> OR <BR> ▸ '''''[[Daptomycin]] 4mg/kg IV q24h''''' | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Linezolid]] 600 mg IV/PO q12h'''''<BR> OR <BR> ▸ '''''[[Daptomycin]] 4mg/kg IV q24h''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #F5F5F5;" align=left | <small>† Vancomycin should be discontinued if culture results remain negative after 72-96 hrs <small> | | style="font-size: 90%; padding: 0 5px; background: #F5F5F5;" align=left | <small>† Vancomycin should be discontinued if culture results remain negative after 72-96 hrs </small> | ||
|- | |- | ||
|} | |} | ||
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| style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen''''' | | style="padding: 0 5px; font-size: 90%; background: #F5F5F5;" align=center | '''''Alternative Regimen''''' | ||
|- | |- | ||
| style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Voriconazole]] 6 mg/kg IV q12h x 1 day, | | style="font-size: 90%; padding: 0 5px; background: #DCDCDC;" align=left | ▸ '''''[[Voriconazole]] 6 mg/kg IV q12h x 1 day, then 3 mg/kg IV q12h'''''<br> OR <br> ▸ '''''[[Voriconazole]] 200 mg PO q12h''''' <br> OR <br> ▸ '''''[[Caspofungin]] 70 mg IV once, then 50 mg IV q24h x ≥ 14 days''''' | ||
|} | |} | ||
|} | |} |
Revision as of 15:26, 5 June 2014
Neutropenic Patients
- Patients with neutropenia require an antimicrobial therapy with a broader coverage.
- The duration of antimicrobial therapy should be individualized in accordance with patient's clinical response.
Microorganism | Duration of Therapy |
▸ Gram-negative Bacteria | 7-14 days |
▸ Gram-positive Bacteria | 7-10 days |
▸ Fungi | Until clinical resolution |
▸ Click on the following categories to expand treatment regimens.
Neutropenia ▸ Gram-Negative Bacteria ▸ Gram-Positive Bacteria ▸ Fungi
|
|
Cellular Immune Deficient Patients
Bacteria ▸ Nocardia spp ▸ Atypical mycobacteria Fungi ▸ Cryptococcus spp ▸ Histoplasma spp Viruses ▸ Varicella-zoster virus ▸ Herpes simplex virus ▸ Cytomegalovirus |
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- ↑ Wheat, LJ.; Freifeld, AG.; Kleiman, MB.; Baddley, JW.; McKinsey, DS.; Loyd, JE.; Kauffman, CA. (2007). "Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America". Clin Infect Dis. 45 (7): 807–25. doi:10.1086/521259. PMID 17806045. Unknown parameter
|month=
ignored (help)