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Neutropenic sepsis after chemotherapy — SCE Acute Medicine MCQ

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HardCancer and Palliative Care and HaematologyNeutropenic sepsis after chemotherapySCE Acute Medicine

Twelve days after chemotherapy, a patient has temperature 38.6°C and neutrophils 0.2 × 10^9/L. She is haemodynamically stable and has no focus. Cultures have been obtained. What is the next step?

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Correct answer: C — Give intravenous piperacillin–tazobactam after cultures

The best answer is “Give intravenous piperacillin–tazobactam after cultures”. This is correct because suspected neutropenic sepsis is an emergency and empiric antibacterial treatment must not await microbiology. Stability does not remove the risk of rapid deterioration. Oral monotherapy, isolated growth-factor treatment and repeat testing without antibiotics leave invasive bacterial infection untreated.

Reference: NICE CG151 neutropenic-sepsis recommendations: https://www.nice.org.uk/guidance/cg151/chapter/Recommendations