By vgreene, 14 April, 2015 Voriconazole 6 mg/kg IV q12h x2, then 4 mg/kg IV q12h; or 400 mg PO bid x2 then 200 mg PO bid
By vgreene, 14 April, 2015 Fluconazole<sup>20</sup> 800 mg IV loading dose then 400 mg IV q24h; or 100-400 mg PO daily
By vgreene, 14 April, 2015 If persistent/recurrent fever + neutropenia:<sup>14,15,16,17</sup> hospitalize pt [S/H]; cx, bx, or excise skin lesion<sup>18</sup> [S/M]; risk-stratify pt<sup>19</sup> [S/M]
By vgreene, 14 April, 2015 If low risk and can take PO meds, consider ciprofloxacin<sup>12,13</sup> + amoxicillin/clavulanate
By vgreene, 14 April, 2015 Initiate empiric abx [S/H]:<sup>6</sup> combine 1 regimen from each group: