Page 84 - HPP ANTIMICROBIAL GUIDELINE 2018

8. The administration of the first dose of empirical anti-pseudomonal antibiotic should be done as soon as possible following
triage (within the first hour) after taking blood cultures. The following regimens are suggested:

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

First line therapy Piperacillin/tazobactam 4.5gm IV q6h Ceftazidime 2gm IV q8h Duration:
OR until neutrophils count recovers to > 500 /u
Cefepime 2gm IV q8h or longer if clinically indicated

**Suspected central device infections,
PLUS/MINUS known colonizers by MRSA, severe
Aminoglycosides mucositis, skin or soft tissue infection
suspected MRSA/MRSE infections and
severe sepsis, septic shock or
PLUS/MINUS respiratory distress.
**Vancomycin 15mg/kg IV q12h OR q8h #Linezolid
# In those with suspected or confirmed
VRE, VISA or VRSA.
Second line therapy Imipenem/cilastatin 500mg IV q8h/q6h
OR
Meropenem 1gm q8h

9. Anaerobic infections account for <5% of all cases of bacteraemia.
a. Metronidazole 500mg IV q8h may be added to cefepime in the presence of severe mucositis, intra-abdominal infections,
peri-anal abscesses or colitis.

HPP AMG Infections In Immunocompromised Patients 37