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Treatment of neutropenic fever syndromes in adults with hematologic malignancies and hematopoietic cell transplant recipients (h...
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"Clostridioides difficile infection in adults: Treatment and prevention".)
Persistent fever — The median time to defervescence following the initiation of empiric antibiotics in patients with hematologic malignancies, including hematopoietic cell transplant (HCT) recipients, is five days, in contrast with only two days for patients with solid tumors [1]. As stated above, modification of the initial antibacterial regimen is not needed for persistent fever alone. However, patients who remain febrile after the initiation of empiric antibiotics should be re-evaluated for possible infectious sources. (See "Diagnostic approach to the adult cancer patient with neutropenic fever".)
Management algorithms have been developed for the reassessment of neutropenic patients (algorithm 2) and after four or more days of persistent fever (algorithm 3) [1]. Key factors in the management of patients with persistent fever include whether the patient is clinically stable, whether there is an identified site of infection, and when the patient is expected to recover from neutropenia. Consideration should be given to the addition of empiric antifungal therapy, as described below. (See 'Addition of an antifungal agent' below.)
September 4, 2026 82 1
