Guidelines for the Management of Febrile Neutropenia

Maritimes FN Guidelines:

I.             Introduction
II.            Definitions
III.           Signs and Symptoms
IV.          Evaluation
V.            Initial Evaluation
               - Table 1 – Guidelines for initial empiric antibiotic selection in patients who presnet as stable and who are not already
                  receiving empiric antibiotics
               - Table 2 – Guidelines for initial empiric antibiotic selection in patients who present as stable but require DUAL antibiotic
                  therapy and who are not alreading receiving empiric antibiotics
               - Table 3 – Guidelines for inital empiric antibiotic selection in patients who presents as unstable and who are not
                  already receiving empiric antibiotics
VI.          Continued Management of Inpatients
VII.         Management based on culture results
              1.  Negative cultures and no clinical focus of infection
               2. Positive cultures
VII.         Management of fever in hematology/oncology patients who have completed therapy and/or are on therapy
              but are not neutropenic
IX.          External Review
X.           Audit and Guideline Update
XI.          References
              Appendix A:  Ideal and Effective Body Weight Formulas for Dosing Adminoglycosides
              Appendix B:  Febrile Neutropenia pre-printed order and algorithm
 

 The supportive care guidelines have been developed by appropriate Atlantic Provinces health professional specialists (physicians, pharmacists, nurses and other health professionals) using evidence-based or best practice references.  Format and content of the guidelines will change as they are reviewed and revised on a periodic basis.  Care has been taken to ensure accuracy of the information.  However, any physician or health professional using these guidelines will be responsible for verifying doses, and administering medications and care according to their own institutional formularies and policies and acceptable standards of care.

 Link to APPHON/ROHPPA Guidelines for the Management of Febrile Neutropenia (June 2017)

 

 Link to APPHON/ROHPPA Treat Promptly Card (March 2017)

 Link to APPHON/ROHPPA French Treat Promptly Card (June 2017)

 Link to APPHON/ROHPPA Quick Reference Guideline for the Management of Febrile Neutropenia in Children (expected March 2015)
 
 

Newfoundland and Labrador - Guideline for Febrile Neutropenia in Pediatric Oncology Patients

  1. Treatment of Febrile Neutropenia in the Pediatric Oncology
  2. Treatment Options
  3. Risk Stratification
  4. Signs and Symptoms of Clinical Instability
  5. References for medication dosing

 Link to Newfoundland & Labrador Guideline for Febrile Neutropenia in Pediatric Oncology Patients - 2015

 Link to Newfoundland & Labrador Treat Promptly Letter - 2013

 

Pre-Printed Order Forms

The IWK Health Centre Pre-printed Orders were developed by IWK Health Centre health professionals to assist in the care of children in their facility.  Format and content of the orders will change as they are reviewed and revised on a periodic basis.  They are included with APPHON supportive care guidelines as a reference to assist health professionals involved in the shared care of children with cancer or a hematological disorder.  Any physician or health professional using these orders as a reference will be responsible for verifying doses, and administering medications and care according to their own institutional formularies and policies and acceptable standards of care.

 Link to APPHON/ROHPPA Febrile Neutropenia Orders and Algorithm - June 2017

 Link to Newfoundland and Labrador Doctor's Pediatric Oncology Patients with FN Order Sheet - 2015