Question: HQ Is A 27 Yo With AML (leukemia) Who Is Admitted To The Hospital 2 Days Ago Where They Have Found An Invasive Fungal Infection In His Lungs And He Is Septic With Staph Growing In His Blood Stream. Micro Confirmed Today That This Is MRSA But We Will Not Know The MIC Until Tomorrow So Need To Assume That The MIC Is 2. HQ Weighs 70 Kg; Has A BUN/Scr Today …

HQ is a 27 yo with AML (leukemia) who is admitted to the hospital 2 days ago where they have found an invasive fungal infection in his lungs and he is septic with Staph growing in his blood stream. Micro confirmed today that this is MRSA but we will not know the MIC until tomorrow so need to assume that the MIC is 2. HQ weighs 70 kg; has a BUN/Scr today of 16/1.0. Yesterday his BUN/Scr were 12/0.8. He was started on Liposomal Amphotericin B, IV voriconazole, and Vancomycin at 1250mg IV q12hrs. MAR (all doses given over 2 hrs due to Redman’s) 4/16 2000 4/17 0830/2000 4/18 0800 Vanc levels 4/18 @0500-15 4/18 @ 1030-30 What are your goals in this situation?