Febrile Neutropenia

Sepsis

Common organisms

  • Gram-negatives incl. Pseudomonas
  • Gram-positives from lines
  • Fungi if prolonged

Empirical therapy

  • Piperacillin-tazobactam 4.5 g IV q8h within 1h
  • Add Vancomycin if line sepsis / shock / MRSA risk

Culture-directed

  • Per cultures; antifungal (Caspofungin) if fever persists >96h
Renal adjustment: Adjust per drug.

Adverse effects

  • Multiple drug interactions

Monitoring

  • Daily review, source identification
  • Repeat blood cultures if persistent fever

Clinical pearls

  • Door to antibiotic <60 min
  • Do not delay for line removal

Educational support only — follow local antibiogram and institutional protocols.

WardRound

WardRound

Clinical Decisions in Seconds