Modification to initial antibiotic regimen based on site-specific evaluation of fever and neutropenia

• Vancomycin only if HoTN, PNA, clinically apparent catheter-related or soft-tissue infxn, gram ⊕ BCx, mucositis + on quinolone Ppx; d/c when BCx ⊖ × 48 h for GPCs
• Mouth/esoph (ulcer, thrush): anaerobic (if necrotizing), anti-HSV and/or antifungal Rx
• Sinus/nasal: add vanc if periorbital cellulitis, ampho if concern for Aspergillus/Mucor
• Abd pain/diarrhea: PO vanc if concern for C. diff; ensure adequate anaerobic coverage
• Lung infiltrates: consider atypical coverage; vanc/linezolid if c/f MRSA; TMP/SMX if c/f PCP
• CNS: ID consult; empiric meningitis Rx (incl. Listeria), high-dose acyclovir for encephalitis