In a cancer patient with fever and suspected neutropenia, what is the recommended antibiotic management?

• A. Delay broad-spectrum antibiotics until culture results are available
• B. Start broad-spectrum antibiotics within 60 minutes of fever onset
• C. Manage fever with antipyretics only and defer antibiotics
• D. Isolate patient and wait for imaging before any antibiotics

Answer: (B)

In cancer patients with fever and suspected neutropenia, infection can progress rapidly because the immune system is severely compromised. The key management step is to start broad-spectrum intravenous antibiotics within 60 minutes of fever onset, even before culture results are back. This approach targets common pathogens, including Pseudomonas, and aims to reduce mortality by treating potential sepsis as an emergency. While you obtain blood cultures and other tests, you should not wait to begin antibiotics; you can tailor therapy later based on culture results and clinical status. Typical initial regimens cover antipseudomonal activity, with adjustments made if there are signs suggesting MRSA, anaerobes, or a specific infection source.