Fast Five Quiz: Antibiotic Best Practices

Mary L. Windle, PharmD

Disclosures

September 11, 2019

ASCO/IDSA guideline recommendations for antibiotic use in patients with neutropenic cancer include the following:

  • Monotherapy with an antipseudomonal beta-lactam agent, such as cefepime, a carbapenem (eg, meropenem or imipenem-cilastatin), or piperacillin-tazobactam is recommended.

  • Other antimicrobials (eg, aminoglycosides, fluoroquinolones, vancomycin) may be added for management of complications (eg, hypotension, pneumonia) or if antimicrobial resistance is suspected or proven.

  • Vancomycin or other agents active against aerobic gram-positive cocci are not recommended as a standard part of the initial antibiotic regimen for fever and neutropenia; such agents should be considered for specific clinical indications, including suspected catheter-related infection, skin or soft-tissue infection, pneumonia, or hemodynamic instability.

According to the ASCO/IDSA guidelines, antibiotic prophylaxis with a fluoroquinolone is recommended for patients who are at high risk for febrile neutropenia or profound, protracted neutropenia (eg, most patients with acute myeloid leukemia/myelodysplastic syndromes or hematopoietic stem-cell transplantation treated with myeloablative conditioning regimens). Antibiotic prophylaxis is not routinely recommended for patients with solid tumors.

Read more about the ASCO/IDSA guidelines.

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