NICE guidance on neutropenic sepsis

Question 1

When should you diagnose neutropenic sepsis in patients having anticancer treatment?

Answer 1

Neutrophil count 0.5 x 109 per litre or lower with either:-
Temp higher than 38
Other signs/symptoms consistent with clinically significant sepsis

Question 2

What 3 pieces of information should patients and carers/family have when they are started on anticancer treatment?

Answer 2

Neutropenic Sepsis
How and when to contact 24 hour specialist oncology advice
How and when to seek emergency treatment

Question 3

In addition to history and examination what tests should be performed when neutropenic sepsis is suspected?

Answer 3

FBC
Renal/Hepatic function (including albumin)
C-reactive protein
lactate
blood cultures

Question 4

What should be given to treat neutropenic sepsis?

Answer 4

Beta Lactam monotherapy with piperacillin with tazobactam as initial empiric antibiotic therapy

Question 5

What should not be offered as therapy for neutropenic sepsis (unless ther are patient specific or local microbiological indications)?

Answer 5

Aminoglycoside either as monotherapy or dual therapy

Question 6

When might outpatient management be acceptable?

Answer 6

Where there is considered to be low risk of septic complications

Question 7

When is discharge acceptable?

Answer 7

RIsk of complications low by suitable healthcare professional and has been assessed using a scoring system
and
Taking into account the patients social and clinical circumstances and discussed with them the need to return to hospital promptly if a problem develops