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🌱 來自: Febrile Neutropenia

Flowchart of a Patient with Neutropenic Fever

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• High risk MASCC score < 21
  • Hematologic malignancy or HCT
  • Anticipated neutropenia ≥ 7 days
• Inpatient management
  • Blood cultures Symptom-directed work-up
  • Daily clinical and laboratory assessment
• Empiric IV antibiotic options
  • Cefepime
  • Piperacillin+tazobactam (if anaerobic coverage needed)
  • Meropenem (if history of ESBL)

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• Low risk MASCC score > 21
  • Solid tumor
  • Anticipated neutropenia ≤ 7 days
  • No hemodynamic instability
• Outpatient management
  • Blood cultures
  • Symptom-directed work-up
  • IV antibiotics (first dose)
  • Observe in clinic for 2-4 hours to ensure stability, oral intake prior to discharge
  • Follow-up within 24 hours in clinic
• On fluoroquinolone prophylaxis
  • Yes: Outpatient IV antibiotic Cefepime
  • No: Oral antibiotic options: Ciprofloxacin plus amoxicillinclavulanate, Levaquin, Moxifloxacin