Febrile Neutropenia Duration of Antibiotics

has CLL. She is neutropenic, febrile at 101° F & admitted to the . Empiric antibiotics are started with an infectious workup . After 72 hours, she has been:

Afebrile x 52 hours
Stable
Workup is negative

What is the BEST antibiotic plan?

A. Monitor off antibiotics
B. Continue until ANC>500
C. Continue until discharge

How did others respond?

Reveal the answer

Best Answer

Monitor off antibiotics 💉

Explanation: 4th European Conference on Infections in Leukemia (ECIL-4) guidelines recommend that antibiotics can be STOPPED 🛑 after 72 hours if:

1. Clinically stable 🤗
2. Afebrile >/= 48 hours 🌡️
3. Infectious work up is negative ➖

ECIL-4 guidelines state that antibiotics can be stopped 🛑 if ALL the above criteria are met REGARDLESS of neutrophil count! 🤯

The HOW LONG trial demonstrated this was a safe approach with no difference in mortality or duration of fever when monitoring off antibiotics vs continuing until neutrophil recovery 📈