Febrile neutropenia is a medical emergency. Empirical broad-spectrum antibiotics should be given within an hour of presentation, after blood cultures but without waiting for the neutrophil count if the patient has had chemotherapy recently and looks unwell.
A validated risk score such as MASCC helps separate patients who may be managed as outpatients with oral antibiotics from those who need admission. Patients receiving chemotherapy should carry clear instructions on what temperature to act on and where to go.
- Take blood cultures and start empirical antibiotics within one hour of presentation.
- Do not wait for the full blood count if recent chemotherapy and fever are present.
- Use a validated score such as MASCC to identify low-risk patients for outpatient care.
- Give every patient on chemotherapy written fever instructions and a contact number.
Why it matters
Delay to the first antibiotic dose is the most modifiable factor in febrile neutropenia outcomes.
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