Neutropenic Fever

Use This Guideline For

Management of Neutropenic Fever in adults

Management of Fever and Hematopoietic Stem Cell Transplant (HSCT) in adults

Note

Neutropenic fever can be highly complex with subtle signs/symptoms of infection. Consider Infectious Diseases consultation in all patients with febrile neutropenia, especially if source cannot be found or patient is febrile for >72 hours.

Definitions

Fever: Temp >38.0C ax or oral (no rectal temps if neutropenic)
Neutropenia: ANC <500

Routine ED Antibiotics

Administer within 60 min of arrival.
Doses need to be adjusted in patients with moderate to severe renal failure.

No PCN Allergy

Meropenem 1 gm IV q8h

OR

Cefepime 2g IV q8h

PCN Allergy

Aztreonam 2g IV q8h

AND

Vancomycin (Dosing per pharmacy)