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Neutropenic Sepsis — SCE Medical Oncology MCQ

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HardOncological EmergenciesNeutropenic SepsisSCE Medical Oncology

After 48 hours of intravenous empirical antibiotics for confirmed neutropenic sepsis, a patient is afebrile, clinically stable, cultures are negative and reassessment with a validated score now places them at low risk. Social circumstances permit rapid return to hospital. What step follows NICE CG151?

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Correct answer: C — Switch to oral antibiotics and consider discharge after competent clinical and social reassessment

CG151 permits switching from intravenous to oral antibiotics after 48 hours when a competent clinician has reassessed the risk as low using a validated score. Discharge additionally depends on clinical and social circumstances and clear return advice. Antibiotic duration is not determined solely by neutrophil recovery, negative cultures do not independently prove treatment can stop, and empiric glycopeptide escalation is not indicated in a responding low-risk patient.

Reference: NICE CG151 neutropenic sepsis recommendations (Updated January 2019): https://www.nice.org.uk/guidance/cg151/chapter/recommendations