Monitoring
Patients require close care from a team comprising a medical oncologist and other healthcare professionals experienced in managing febrile neutropenia.
For high-risk patients admitted to hospital, daily follow-up is required, which should include history, physical exam (including site-specific assessment), routine laboratory tests, and evaluation of response to empiric treatment. Clinical assessment may be required every 2 to 4 hours for patients requiring resuscitation. Daily assessment is recommended until the patient is afebrile and has an absolute neutrophil count ≥500 cells/microliter.[59] There are no official recommendations for monitoring once the patient is afebrile and has ceased antibiotics.
For high-risk patients undergoing inpatient management (and those who are otherwise admitted), observation and monitoring parameters prior to and after discharge will depend on illness acuity.
For low-risk patients undergoing outpatient management, there is an obligatory period of observation for ≥4 hours prior to discharge, with clear instructions on what should trigger a prompt return to the hospital or other healthcare facility.[57]
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