試題詳解

113. LB is a 25 year-old female with AML day 24 s/p 7+3 induction (anthracycline plus cytarabine). Her course has been complicated by culture negative febrile neutropenia with chest x-ray findings (day 20) suggestive of pneumonia. She has received cefepime since day 20. She has been afebrile for 72 hours and has now recovered her neutrophil count. Your leukemia team would like to know when it would be appropriate to discontinue antibacterials. Which of the following is most appropriate response?
(A) LB should stop cefepime since neutropenia has resolved and has been afebrile for at least 2 days
(B) LB has received an adequate course for pneumonia therefore cefepime can be discontinued
(C) LB has received an adequate course for pneumonia and cefepime can be switched to levofloxacin prophylaxis
(D) LB has not received an adequate course for pneumonia but can be de-escalated to oral stepdown therapy to complete her treatment