Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

Neutropenic

Empiric Regimen

Caspofungin 70 mg IV x1 then 50 mg IV daily

See febrile neutropenia for more details. Link is available below.

OR

Fluconazole 800mg (or 12 mg/kg) IV or oral loading dose, then 400mg (6 mg/kg) IV or orally daily

Duration of Therapy

Minimum 14 days after negative blood culture.

Tailor with source and other foci of infection.

Comments

Empiric Fluconazole should only be used in clinically stable patients with no prior azole exposure including prophylaxis.

Change to Fluconazole once clinically stable, repeat blood cultures are negative, and susceptibility is established.

Febrile Neutropenia