A. Studies show that more than 80% of children with cancer having fever (as earlier defined) and moderate neutropenia who are carefully chosen as defined below may be managed successfully either as outpatients or hospitalized briefly (12-48 hours) and then followed as outpatients. They should: 1. Be older than 1 year of age.
Have no significant source of infection (e.g., perirectal abscess, central line tunnel cellulitis).
Have ANC >200/uL and anticipation that it will increase.
Have a remission status of their cancer.
Not be a bone marrow transplant recipient.
Not have recent surgery.
Have no moderate or severe mucositis.
B. Such patients can receive monotherapy such as ceftazidime or ceftriaxone or one of these agents combined with an aminoglycoside. However, they must be examined and evaluated daily by a physician experienced in caring for immune-compromised children.