Neutropenic Sepsis - Non Haematology / Oncology

First Line

Piperacillin-Tazobactam (Tazocin) 4.5g IV 6 hourly +/- Gentamicin IV as per protocol

 

 

Add Vancomycin IV as per protocol if line in-situ or previous MRSA

Penicillin Allergy

 Vancomycin IV as per protocol AND Gentamicin IV as per protocol AND Metronidazole 500mg IV 8 hourly

If concerns regarding nephrotoxicity e.g. acute kidney injury - replace Gentamicin with Ciprofloxacin 750mg PO 12 hourly / 400mg IV 8 hourly

Notes

Send blood cultures  and other relevant samples

Check previous / recent microbiology results for guidance

Check previous MRSA status

 

 

Treatment duration: Guided by source of infection after investigation and clinical response. Refer to appropriate header in guidance.  

 

If there is treatment failure/relapse check microbiology results, seek senior clinical review +/- discuss with Microbiology consultant.