What should be given to a patient with a fever of unknown origin and neutropenia?

In the scenario of a patient presenting with a fever of unknown origin and neutropenia, the appropriate choice is Zosyn, which is a combination of piperacillin and tazobactam. The rationale behind this treatment revolves around the need to cover a broad spectrum of potential pathogens, particularly considering that neutropenic patients are at high risk for infection due to their compromised immune systems.

Zosyn is effective against both gram-positive and gram-negative bacteria, as well as some anaerobes. This broad-spectrum coverage is crucial in the context of febrile neutropenia, where common sources of infection include bacteria from skin flora, urinary tract infections, and gastrointestinal organisms. In such settings, a combination agent like Zosyn can address the various possible infectious agents, particularly for empiric therapy in neutropenic patients.

While other antibiotics like vancomycin, meropenem, and clindamycin may be appropriate under specific circumstances, the extensive coverage provided by Zosyn makes it a preferred empiric choice in the initial management of febrile neutropenia. Vancomycin could be considered if there is suspicion of MRSA, and meropenem provides broad coverage for more resistant organisms, but the empir