Antifungal prophylaxis – prolonged neutropenia — RACP Paediatrics MCQ

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ModerateIDAntifungal prophylaxis – prolonged neutropeniaRACP Paediatrics

A child on intensive chemotherapy has an ANC expected to be <0.5 for >7 days. PJP prophylaxis is already prescribed. What additional antimicrobial prophylaxis should be considered during prolonged neutropenia?

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Correct answer: D — Antifungal prophylaxis

Antifungal prophylaxis (fluconazole or posaconazole depending on local guidelines) is recommended during prolonged neutropenia (>7 days) to prevent invasive fungal infections (Candida, Aspergillus). The choice depends on the expected duration of neutropenia and local fungal epidemiology.

Reference: RCH Melbourne – 2023 – Febrile Neutropenia CPG; Australian Therapeutic Guidelines – 2024