Outpatient treatment of low-risk neutropenic fever

Diagnosis Common Pathogens Drug(s) of First Choice Alternative Drug(s) Comments Expected Duration
Outpatient treatment of low-risk neutropenic fever

Streptococci spp.

Enteric gram-negative bacteria

Pseudomonas aeruginosa

Enterococci

Staphylococci

Viral infections

Fungal infections

Ciprofloxacin

PLUS

Amoxicillin/clavulanic acid
Levofloxacin

Need to take into account how sick the patient is at presentation, underlying comorbidities, localizing signs/symptoms, and age. Risk calculators are available

Expected duration of neutropenia should be < 7 days

Ensure patient has easy access to medical care and is able to tolerate oral therapy

Excludes patients on prior oral antibacterial prophylaxis

Consider supervised observation in clinic; schedule close outpatient follow-up

Until afebrile at least 72 hours

If source identified, tailor for source of infection