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Table 1 Empiric antibiotic therapy in high risk patients with neutropenic fever (adapted from the IDSA guidelines[4])

From: How to treat severe infections in critically ill neutropenic patients?

Antibiotherapy Indications Grade of recommendation
Antipseudomonal β-lactam agent All high risk patients with neutropenic fever A-I
- Carbapenem (meropenem or imipenem-cilastatin)
Piperacillin-tazobactam
Aminoglycosides Hemodynamic instability B-III
Vancomycin - Suspected catheter-related infections A-I
- Skin or soft-tissue infection
- Hemodynamic instability
Vancomycin, linezolid or daptomycin Risk of methicillin-resistant Staphylococcus aureus B-III
Linezolid or daptomycin Risk of vancomycine-resistant enterococcus B-III
Carbapenem Risk of extended-spectrum β-lactamase-producing gram negative bacteria B-III
Polymyxin-colistin or tigecycline Risk of Klebsiella pneumonia carbapenemase (KPC) C-III
- Ciprofloxacin + clindamycin Penicillin-allergic patients A-II
- Aztreonam + vancomycin