Anbx in Neutropenic Fever

Q: Out of the following which one is the least preferred in neutropenic patients (in USA)

A) Cefepime
B) Meropenem
C) Imipenem-cilastatin
D) Piperacillin-tazobactam 
E) Ceftazidime


Answer: E

In USA, there is an increasing tendency of resistance for ceftazidime 1. Fever in high-risk neutropenic patients is a medical emergency, up to the point that now it is argued to administer empiric broad-spectrum antibiotics within 30 minutes instead of typical 60 minutes for other causes of sepsis 2. There is a very little room to afford resistance.

#infectiousdiseases



References:

1.  Initial management of fever and neutropenia (link here) © 2018 UpToDate, Inc.

2. Rosa RG, Goldani LZ. Cohort study of the impact of time to antibiotic administration on mortality in patients with febrile neutropenia. Antimicrob Agents Chemother 2014; 58:3799.