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Neutropenia and Cellular Immune Deficient Patients

▸ Click on the following categories to expand treatment regimens.

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
[[
Alternative Regimen
[[
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.[1]
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 x 7-10 days
OR
Famciclovir x 7-10 days
OR
Valacyclovir x 7-10 days
Alternative Regimen
[[
Herpes simplex virus
Preferred Regimen
Acyclovir x 7 days
OR
Famciclovir x 7 days
OR
Valacyclovir x 7 days
Alternative Regimen
[[
Cytomegalovirus
Preferred Regimen
Ganciclovir x 21 days
Alternative Regimen
[[
  1. 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)