Neutropenic Patients
▸ Click on the following categories to expand treatment regimens.
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Gram-Positive Bacteria
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Preferred Regimen
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▸ Vancomycin† 15-20 mg/kg IV q8-12h
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Alternative Regimen
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▸ Linezolid 600 mg IV/PO q12h OR ▸ Daptomycin 4mg/kg IV q24h
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† Vancomycin should be discontinued if culture results remain negative after 72-96 hrs
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Cellular Immune Deficient Patients
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Nocardia spp
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Preferred Regimen
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▸ TMP-SMX x 3-12 months
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Alternative Regimen 1
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▸ Sulfadiazine 2-4 g PO 1 dose
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FOLLOWED BY
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▸ Sulfadiazine 2-4 g/day PO q4-8h x 3-12 months
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Alternative Regimen 1
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▸ Imipenem 250-500 mg IV q6-8h x 3-12 months
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Atypical mycobacteria
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Preferred Regimen
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▸ [[combination therapy (duration, 6–12 weeks) with macrolide antibiotic (clarithromycin
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Alternative Regimen
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▸ [[
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Varicella-zoster virus
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Preferred Regimen
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▸ Acyclovir 10-12 mg/kg IV (infusion over 1 hour) q8h x 7-10 days
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Alternative Regimen
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▸ Famciclovir 500 mg PO x 7-10 days OR ▸ Valacyclovir 500 mg PO x 7-10 days
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Herpes simplex virus
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Preferred Regimen
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▸ Acyclovir 10 mg/kg IV (infusion over 1 hour) q8h x 7-10 days
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Alternative Regimen
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▸ Famciclovir 500 mg PO x 7 days OR ▸ Valacyclovir 500 mg PO x 7 days
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Cytomegalovirus
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Preferred Regimen
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▸ Ganciclovir 5 mg/kg IV q12h x 21 days
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Alternative Regimen
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▸ Valganciclovir 900 mg PO q12h x 21 days
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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.