INFECTIOUS DISEASE

ResponseFocal symptoms ? source
Degree of illness - severity of symptoms
Last chemotherapy - predict degree of neutropaenia
Underlying disease/limits of care/theraputic goals
Presence of lines/indwelling devices
Comorbidities - cardiac (chemo), Immunomodifiers (DM)

ResponseVital signs - severity of illness
Focal findings - guide therapy
Lines/ports - ? Line sepsis

ResponseTazocin 4.5g

• Broad spectrum with Garm +/- cover
• Staph, pneumococcus, pseduamonas, intestinal organisms

Gentamycin 5mg/kg (if ICU sick)

• Gram neg cover
• E. Coli, Pseudomonas

Vancomycin 30 mg/kg (If ICU sick/line sepsis suspected)

• MRSA/MSSA (Think of line sepsis)

ResponseAllergies - avoid specific drugs
Investigation results - eg: targeted antibiotics for likely source
Past micro/resistance - Initial cover should extend to cover everything
Presence of lines/IDC - Needs staph + MRSA cover
Local protocols - Local prevalence may require VRE/ESBL cover
Comorbididites - Eg renal faluire may require differing dose/drug