Guidelines for Complications of Cancer Treatment Vol VIII Part B

Febrile NeutropeniaNeutropenia is well known complication of chemotherapy.Neutropenia predisposes to infections which is a major causeof morbidity and mortality. Specific guidelines is providedfor diagnosis, treatment and prevention of febrile neutropenia.This guidelines should be used in conjunction with patientevaluation, host factors analysis and especially microbes andantimicrobial sensitivity pattern at the local place.DefinitionFever is defined as single oral temperature 38.3 C or moreorally or 38 C or more over 1 hour without obvious cause. Apatient with neutropenia and signs of infection should betreated as febrile neutropenia.Initial EvaluationA site specific history and examination should be done. Cultureshould be obtained and antibiotic should be startedimmediately. Common sites of infection such asgastrointestinal tract, lung, sinus, ears, perivagina, perirectum,skin, groin and central venous catheter shold be examined.Important features to consider are co-morbid features, lastchemotherapy date and recent antibiotic use. (level-3)373