Add IV amikacin to current regimen and remove the PICC.
Patients with pseudomonal bacteremia should be treated initially with 2 agents with activity against Pseudomonas until sensitivity data are available. Broad-spectrum coverage should be continued in patients with febrile neutropenia, especially those with mucositis. Vascular access devices can be left in place if there is no sign of tunnel infection. However, if bacteremia is still present or there is evidence of catheter-site infection, the device should be removed.