This guideline is not intended for the treatment of Severe Sepsis/Septic Shock
Dose recommendations are based on patients with normal renal function. Refer to dosing in renal impairment
These guidelines may not be appropriate for patients with a history of multi-drug resistant organisms. Consider infectious disease consultation
Meets ANC AND Temperature Criteria:
H&P for localizing findings
History of multi-drug resistant organisms (MDRO)
Receipt of prophylactic antibiotics (ex. Levofloxacin)
Presence of organ dysfunction
Drug allergies
Blood cultures x 2 for all patients
Additional cultures as indicated by suspected source
50% of episodes are of unknown source
Median time to defervescence is ~5 days
Avoid fluoroquinolones if receiving them prophylactically
ANC >500 on at least one occasion with an increasing trend
Antimicrobials may be narrowed to target cultured organisms
These recommendations are meant to guide empiric therapeutic decision making and are not meant to replace sound clinical decision making. Definitive therapy should be based on culture and susceptibility reports
Adapted from the Northern Light Eastern Maine Medical Center Antimicrobial Stewardship Program