This guideline covers preventing, identifying and managing neutropenic sepsis in children, young people and adults receiving treatment for cancer in the community and in secondary and tertiary care. It aims to reduce the risk of infection in people with neutropenia (low number of white blood cells) who are receiving anticancer treatment and improve management of neutropenic sepsis.
A table of NHS England interim treatment regimens gives possible alternative treatment options for use during the COVID-19 pandemic to reduce infection risk. This may affect decisions for patients with cancer. See the COVID-19 rapid guideline: delivery of systemic anticancer treatments for more details.
Fluoroquinolone antibiotics: In January 2020, we updated this guideline to reflect MHRA restrictions and precautions for the use of fluoroquinolone antibiotics following rare reports of disabling and potentially long-lasting or irreversible side effects (see Drug Safety Update and update information for details).
This guideline includes recommendations on:
- information and support for patients and carers
- reducing the risk of neutropenic sepsis
- referring patients in the community with suspected neutropenic sepsis
- managing suspected neutropenic sepsis in secondary and tertiary care
- managing confirmed neutropenic sepsis
Who is it for?
- Healthcare professionals
- People receiving treatment for cancer and their families and carers
Is this guideline up to date?
We checked this guideline in January 2020. We found no new evidence that affects the recommendations in this guideline.
Guideline development process
This guideline was previously called neutropenic sepsis: prevention and management of neutropenic sepsis in cancer patients.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.