Spectrum: Local Antimicrobial Stewardship, for IWK Health Centre

Febrile Neutropenia(Oncology Patients): Stable Patients

Most Likely Pathogens

E.coli

Klebsiella

Other Enterobacteriaciae

S.aureus

S. viridans

Pseudomonas aeruginosa

Suggested Regimen

Discuss with Pediatric Oncologist

Dosing is based on the piperacillin component:
Piperacillin-Tazobactam 80 mg/kg/dose IV q8h
Maximum: 4000 mg/dose

Penicillin Allergy or Receiving High Dose Methotrexate or Leucovorin Rescue

Cefepime 50 mg/kg/dose IV q8h
Maximum: 2000 mg/dose

OR IF CEFEPIME UNAVAILABLE

Ceftazidime 50 mg/kg/dose IV q8h
Maximum: 2000 mg/dose

AND

Vancomycin:
Under 12 years:
12.5 mg/kg/dose IV q6h
Maximum: 1000 mg/dose before levels

12 years and older:
1000 mg IV q12h