• Rohen Skiba, Nisha Sikotra, Timothy Ball, Astrid Arellano, Eli Gabbay, and Timothy D Clay.
• Research Department, St John of God Healthcare, Perth, Western Australia, Australia.
• Intern Med J. 2020 Aug 1; 50 (8): 959-964.

BackgroundNeutropenic fever is a medical emergency, which poses a significant morbidity and mortality risk to cancer patients receiving chemotherapy. National guidelines recommend that patients presenting with suspected neutropenic fever receive appropriate intravenous antibiotics within 60 min of admission.AimWe aimed to investigate the management of neutropenic fever in a large private oncology centre.MethodsA retrospective audit of all patients who presented to St John of God Hospital, Subiaco, in the 2017 calendar year, with a known solid organ malignancy and a recorded diagnosis of neutropenic fever was conducted. Patients were identified through the hospitals Patient Administration System and ICD-10 codes. Information was collected from the hospital medical records using a standardised data collection tool.ResultsThere were 98 admissions relating to 88 patients with neutropenic fever during the study period. The median age was 64 years (range: 23-85 years) with 57 (65%) females. Antibiotic selections consistent with the Australian guidelines were made in 88 (89%) admissions. The mean time to antibiotic administration was 279 min, with a median of 135 min (range: 15-5160 min). Antibiotics were administered within the recommended time frame in only eight (11%) admissions.ConclusionClinicians prescribed antibiotics in accordance with national guidelines; however, there were systemic inefficiencies which resulted in delayed antibiotic initiation. This has resulted in implementation of strategies to minimise delay.© 2019 Royal Australasian College of Physicians.

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