Febrile neutropenia – antibiotics in 60 min — RACP Paediatrics MCQ

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EasyIDFebrile neutropenia – antibiotics in 60 minRACP Paediatrics

A 6-year-old on chemotherapy for ALL presents with fever (38.5°C single reading) and an ANC of 0.3 × 10⁹/L. She looks well. What is the most appropriate initial management?

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Correct answer: D — Febrile neutropenia protocol

Febrile neutropenia (fever ≥38°C with ANC <0.5 × 10⁹/L) in an oncology patient is a medical emergency regardless of how well the child appears. The febrile neutropenia protocol requires: blood cultures (peripheral + central line), broad-spectrum IV antibiotics (e.g., piperacillin-tazobactam) within 60 minutes, and close monitoring. Risk stratification guides further management.

Reference: RCH Melbourne – 2023 – Febrile Neutropenia CPG; RACP Paediatric Curriculum – Oncology/ID