A patient on chemotherapy with fever should be treated as having febrile neutropenia until the count is known. Broad-spectrum intravenous antibiotics are given within an hour of arrival, after blood cultures but without waiting for the neutrophil count. Risk scores such as MASCC then help identify low-risk patients who may complete treatment orally or as outpatients.
- Give chemotherapy patients a written plan to attend urgently with fever.
- Start intravenous broad-spectrum antibiotics within one hour of arrival.
- Take blood cultures first, but do not wait for the neutrophil count.
- Use a validated risk score to identify low-risk patients for oral or outpatient care.
Why it matters
Delay in the first hour is the most avoidable cause of death in febrile neutropenia.
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