Line Infection — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateSupportive & Palliative OncologyLine InfectionSCE Medical Oncology

A 58-year-old woman receiving chemotherapy develops febrile neutropenia. Blood cultures grow Staphylococcus epidermidis from her Hickman line. She has been started on piperacillin-tazobactam per NICE CG151. What additional antibiotic should be considered for suspected line infection?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Vancomycin (or teicoplanin) for Gram-positive line infection coverage

Coagulase-negative staphylococci (e.g. S. epidermidis) are the most common cause of central venous catheter-related bloodstream infections (CRBSI). When CRBSI is suspected (positive blood culture from the line, differential time-to-positivity), vancomycin (or teicoplanin) should be added to the empiric anti-Gram-negative regimen (piperacillin-tazobactam). NICE CG151 states that glycopeptide antibiotics should not be added routinely but should be considered when CRBSI is suspected or confirmed. Line removal may be required for persistent/complicated CRBSI.

Reference: NICE CG151 Neutropenic sepsis; BNF Vancomycin; ESMO 2024 Supportive Care