Updated Recommendations for Treating Febrile Neutropenia

Empiric treatment of patients with febrile neutropenia has trended toward monotherapy, typically with cefepime, piperacillin/tazobactam, or a carbapenem. These new guidelines update treatment recommendations in the context of stewardship principles, emerging gram-negative resistance, and the availability of newer broad-spectrum agents.

Key Recommendations

• Empiric piperacillin/tazobactam or cefepime is appropriate for most patients with febrile neutropenia. Notable exceptions are as follows:

  • Patients previously colonized or infected with extended-spectrum beta-lactamase–producing organisms should receive a carbapenem.

  • Patients pr…