The management of febrile neutropenia

Febrile neutropenia is a serious, life-threatening condition. Microbes, which invade via minor breaches in the skin or mucous membranes, rapidly lead to overwhelming infection. Early intervention with broad-spectrum intravenous antibiotics has been the cornerstone of treatment for over 30 years and has resulted in a significant reduction in mortality. The prolonged hospitalisation associated with these intensive treatment regimes creates major disruption for the children and their families and, in some cases, leads to long-term psychosocial problems. Development of new, more flexible antibiotic policies, risk stratification of patients and the use of prophylactic antimicrobials are aimed at safe reduction in frequency and length of inpatient admissions with consequent reduction in morbidity but without deleterious effect on morbidity.