Consensus guidelines for the subsequent management of neutropenic fever after empiric therapy

In the context of significant advances in the literature, this chapter of the 2024 Australasian Consensus Guidelines for the Management of Neutropenic Fever in Patients with Cancer addresses the management of patients beyond the first 72 h, focusing on high-risk patients. A writing group - including adult and paediatric representatives across infectious diseases, microbiology, haematology, transplant and oncology across Australia and New Zealand, as well as across craft groups, including medicine, nursing and pharmacy - was developed to produce and address key management questions, overseen by a steering committee that included consumer representation. This chapter follows on from the Initial Empiric Management chapter and it complements the Ambulatory Care chapter, which is dedicated to low-risk patients. Using an extensive review of the literature, these guidelines provide consensus recommendations with evidence grading on topics including investigation of persistent and recurrent fever, common causes of non-infection-related fever and antibiotic rationalisation options, such as cessation, de-escalation and targeted therapy.