Chemotherapy-Induced Fever and Neutropenia

Criteria

Inclusion Criteria

Patients who are receiving steroids during ALL induction or re-Induction for relapse may not develop fever with infection. If afebrile but ill and neutropenic, they should be treated according to the algorithm.
This algorithm applies to patients with unclear source of fever. If suspected source or organism isolated, coverage should be directed toward identified organisms and/or source.

Select All That Apply

Fever ≥38°C (100.4°F) AND ANC <500

Note - Patients may receive initial dose of antibiotic for suspected neutropenia prior to CBC confirmation. Please select this option to proceed.

Increased Gram Positive Risk

AML therapy or high dose Ara-C (>1000 mg/M²/ dose)
S/P limb salvage
History of invasive MRSA infection or colonization
Prior S. viridans sepsis
Signs of catheter site or soft tissue infection

Comorbidities

Need for pressor support
Need for respiratory support
Poor perfusion
Altered mental status
Pending ICU admission or signs of multiple organ dysfunction
History of MDRO