Right Decisions
TAM (Treatments and Medicines) NHS Highland
ADULT THERAPEUTIC GUIDELINES
ANTIMICROBIAL GUIDANCE
Systemic (Antimicrobial)
Back
Neutropenic Sepsis (Antimicrobial)
Neutropenic sepsis: Ongoing management: in-patients with febrile neutropenia: Day 2 to 3 (Antimicrobial)

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Neutropenic sepsis: Ongoing management: in-patients with febrile neutropenia: Day 2 to 3 (Antimicrobial)

TAM (Treatments and Medicines) NHS Highland

Drug details

If patient not improving or deteriorating after 48 to 72 hours (D2 to 3) and no positive culture: seek consultant approval

SWITCH to IV meropenem 1g every 8 hours

If patient still not improving or deteriorating after 48 to 72 hours (D5 to 6) and no positive culture: seek consultant approval

ADD IV caspofungin 70mg once daily

If patient weighs less than 80kg, give caspofungin 70mg stat then 50mg once daily thereafter

If fungal infection strongly suspected and patient not improving or is deteriorating after 72 hours (D8) of caspofungin

SWITCH to IV Ambisome^® 3mg/kg once daily

After initial test dose, give full 3mg/kg dose (rounded to the nearest 50mg vial). Do not increase dose gradually to 3mg/kg.

Last reviewed: 27/04/2023

Next review date: 27/04/2026

Author(s): Antimicrobial Management Team.

Version: 3

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Alison Macdonald, Area Antimicrobial Pharmacist.

Document Id: AMT188