Neutropenic sepsis

Question 1

describe the management of neutropenic sepsis.

Answer 1

start empirical antibiotics
- Piperacillin + Tazobactam

if febrile and still unwell after 48 hours then consider Meropenem + Vancomycin

if not responding by 4-6 days then carry out investigations for fungal infections (don’t start empirical antifungals)

Question 2

what is the criteria for diagnosis of neutropenic sepsis?

Answer 2

neutrophil count of < 0.5 x 10(9) in a patient receiving cancer treatment plus one of the following;

• temperature > 38
• signs/symptoms of significant sepsis

Question 3

what prophylaxis is given to patients at risk of neutropenia?

Answer 3

fluoroquinolone e.g. ciprofloxacin

Question 4

when does febrile neutropenia typically occur?

Answer 4

7-14 days after chemotherapy