A patient on chemotherapy with fever and a low or expected-low neutrophil count is treated as having a life-threatening infection until shown otherwise. Standard practice is broad-spectrum intravenous antibiotics within an hour of presentation, after blood cultures but without waiting for the count to come back if neutropenia is likely.
Delays usually happen at triage, when a well-looking patient waits behind sicker ones. A written pathway and a direct oncology contact line close that gap.
- Give empirical intravenous antibiotics within an hour of a febrile patient on chemotherapy arriving.
- Take blood cultures first, but do not delay antibiotics for results.
- Do not wait for the neutrophil count when chemotherapy timing makes neutropenia likely.
- Give patients a card with their regimen and an emergency contact number.
Why it matters
Every hour of delay in febrile neutropenia raises the risk of death.
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