Clinical Pathway for Oncology Patient Presenting with New Fever
- Related Pathways
- As Clinically Indicated
Team Assessment
- History and Physical Exam
- Obtain CVC or IV access
- Order labs and blood cultures, consider further diagnostic studies
- Review considerations for antibiotic choice and order antibiotics as indicated
- Contact Oncology after placing orders
- Consider stress steroids (except for CAR T-cell recipients)
- Avoid ibuprofen
General oncology, autologous SCT, CAR T-cell ≥ 1 mo
- Antibiotic Recommendations for Special Populations
- CAR T-cell < 1 mo
- Allogeneic Stem Cell Transplant
- Gene Therapy Recipients
Broviac, PICC, Medcomp/Pheresis Catheter
Port
No Line
Check ANC
Can use ANC within past 24 hrs
Can use ANC within past 24 hrs
Check ANC
Can use ANC within past 24 hrs
Can use ANC within past 24 hrs
ANC < 200
ANC ≥ 200
ANC < 200
ANC ≥ 200
No antibiotics indicated
Does not meet all criteria
Meets all criteria
Discharge home
Does not meet all criteria
Meets all criteria
Discharge home
Evidence
- Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update
- Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of America
- Prevention and Treatment of Cancer-related Infections, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology
- Guideline for the Management of Fever and Neutropenia in Pediatric Patients With Cancer and Hematopoietic Cell Transplantation Recipients: 2023 Update
CHOP Program
