Can febrile neutropenia re-invent its self?

Febrile neutropenia as a complication of cytotoxic chemotherapies, remains a major event in the medical journey of hematology and oncology patients. In this review, we are trying to review the new elements and highlights that are shaping febrile neutropenia in nowadays.

Introduction of risk-stratification, expanded use of granulocyte-colony stimulating factor and oral treatment for selected patients and rapid administration of antibiotics revolutionized the treatment of febrile neutropenia. Oral treatment with moxifloxacine or amoxicillin-clavulanate + ciprofloxacin has already been widely tested and is actually a standard of care for a meticulously selected group of patients managed as ambulatory patients. Intravenous treatment of febrile neutropenia is a major challenge for clinicians and microbiologists since the blast of the "silent pandemic" of antimicrobial resistance.

In this setting, strategies that reduce the chances of febrile neutropenia, misuse of antibiotics and enhance the rigorous control of infections may offer a chance to improve the management of febrile neutropenia and offer to our patients the chance to continue their antineoplastic treatment without perturbations.